Leger A F
Service Central des Radio-Isotopes, Hôpital Necker-Enfants Malades, Paris.
Ann Endocrinol (Paris). 1993;54(4):241-7.
Thyroid scintigraphy is required during the initial assessment of an isolated thyroid nodule. This is the only means of diagnosing a hot, cold or self-fixing nodule. The isotope used can be either radioactive iodine or pertechnetate Tc04. For a number of authors, the best images are obtained with iodine; Tc04 is less expensive and easily available. Only scintigraphy can highlight the true problems. Is a cold nodule benign or malignant? A fine-needle aspiration biopsy is performed, then controlling the size if surgery is unnecessary. Is it a hot toxic nodule, or is it likely to become toxic? The ultrasensitive TSH is monitored. The malignant hot nodule problem remains theoretical. Well-documented observations are still rare. The role of scintigraphy in the initial sequence of an isolated nodule investigation is discussed. The main limit of scintigraphy, which is its poor resolution, may offer the advantage of reducing ultrasound microsemiology abuse.
在对孤立性甲状腺结节进行初始评估时需要进行甲状腺闪烁扫描。这是诊断热结节、冷结节或自固定结节的唯一方法。所使用的同位素可以是放射性碘或高锝酸盐Tc04。对于许多作者来说,使用碘可获得最佳图像;Tc04成本较低且易于获得。只有闪烁扫描才能突出真正的问题。冷结节是良性还是恶性?进行细针穿刺活检,然后在不需要手术时控制其大小。它是热毒性结节,还是可能会变成毒性结节?监测超敏促甲状腺激素。恶性热结节问题仍然只是理论上的。有充分记录的观察结果仍然很少。本文讨论了闪烁扫描在孤立结节调查初始流程中的作用。闪烁扫描的主要局限性在于其分辨率较差,但这可能具有减少超声微半定量滥用的优势。