Yen T C, Lin H D, Lee C H, Chang S L, Yeh S H
Department of Nuclear Medicine, Veterans General Hospital-Taipei, Taiwan.
Eur J Nucl Med. 1994 Sep;21(9):980-3. doi: 10.1007/BF00238123.
Thirty-seven patients with Hürthle cell carcinoma of the thyroid gland underwent total thyroidectomy and then technetium-99m sestamibi (2-methoxy-isobutylisonitrile), iodine-131 and thallium-201 whole-body scans. Twenty-two of them had elevated human serum thyroglobulin (HTg) levels. Among these 22 patients, abnormal uptake of 131I was seen in four (18.1%), abnormal uptake of 201Tl chloride in 15 (68.1%), and abnormal 99mTc-sestamibi accumulation in 18 (81.8%). No patients with normal levels had a positive whole-body scan. In comparison with the 131I and 201Tl chloride images, the 99mTc-sestamibi images were of superior quality and detected significantly more (P < 0.05) metastatic lesions of Hürthle cell carcinoma of the thyroid gland in patients with elevated HTg after total thyroidectomy. A mechanism is proposed that may explain these findings.
37例甲状腺嗜酸性细胞癌患者接受了甲状腺全切除术，随后进行了锝-99m甲氧基异丁基异腈、碘-131和铊-201全身扫描。其中22例患者的人血清甲状腺球蛋白（HTg）水平升高。在这22例患者中，4例（18.1%）出现碘-131摄取异常，15例（68.1%）出现氯化铊-201摄取异常，18例（81.8%）出现锝-99m甲氧基异丁基异腈聚集异常。HTg水平正常的患者全身扫描均为阴性。与碘-131和氯化铊-201图像相比，锝-99m甲氧基异丁基异腈图像质量更高，在甲状腺全切除术后HTg升高的患者中，检测到的甲状腺嗜酸性细胞癌转移灶明显更多（P<0.05）。本文提出了一种可能解释这些发现的机制。
