Tindall H, Griffiths A P, Penn N D
Department of Medicine, General Infirmary, Leeds, UK.
Postgrad Med J. 1987 Oct;63(744):869-71. doi: 10.1136/pgmj.63.744.869.
One hundred and thirty-one consecutive requests for thyroid scintigraphy were analysed to assess their diagnostic contribution to the subsequent medical management of the patient. Forty one per cent of requests were to investigate the presence of a clinically detectable solitary nodule and, of these, one fifth had hot nodules. Diffuse goitres accounted for 38% of all referrals, but in only two patients (non-toxic hot nodule) did the results change management. A further 11% of referrals were for multinodular goitres and 8% for retrosternal goitres. In all cases of goitre no additional useful information was obtained from scintigraphy. It is concluded that thyroid scintigraphy was an unnecessary investigation in approximately 45% of cases. Its primary role was in the investigation of the solitary nodule and in detecting toxic nodules in thyrotoxic patients who had no evidence of Graves' disease. Greater discrimination of requests would avoid investigating patients unnecessarily and reduce costs.
对连续131例甲状腺闪烁扫描检查申请进行了分析，以评估其对患者后续医疗管理的诊断贡献。41%的申请是为了调查临床上可检测到的孤立性结节，其中五分之一有热结节。弥漫性甲状腺肿占所有转诊的38%，但只有两例患者（非毒性热结节）的检查结果改变了治疗方案。另有11%的转诊是为了多结节性甲状腺肿，8%是为了胸骨后甲状腺肿。在所有甲状腺肿病例中，闪烁扫描未获得额外有用信息。得出的结论是，在大约45%的病例中，甲状腺闪烁扫描是不必要的检查。其主要作用是调查孤立性结节以及检测无格雷夫斯病证据的甲状腺毒症患者中的毒性结节。对申请进行更严格的甄别将避免不必要地对患者进行检查并降低成本。
