Bakheet S, Hammami M M
Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Eur J Nucl Med. 1993 May;20(5):415-9. doi: 10.1007/BF00209000.
In patients with differentiated thyroid cancer, radioiodine uptake in the mediastinal area most often indicates thyroid cancer metastasis. We review 15 radioiodine whole-body scans showing 19 mediastinal artefacts that mimicked lymph node or spinal metastasis. The artefacts disappeared on delayed images after eating and drinking (17) or on studies repeated within 1 week (2), suggesting their oesophageal origin. No patient had clinical oesophageal or gastric disease. Only two artefacts were linear; 12 were focal and five were diffuse. Twelve artefacts were better seen on anterior views (nine in the upper, two in the middle and one in the lower mediastinal area), whereas seven were better seen on posterior views (two in the upper, two in the middle, and three in the lower mediastinal area). The 15 scans were identified from about 1000 scans performed over 24 months in our centre. We conclude that the transient presence of radioiodine in an apparently normal oesophagus may not uncommonly mimic mediastinal lymph node or spinal metastases from thyroid cancer and that its scintigraphic presentation is variable.
在分化型甲状腺癌患者中，纵隔区域的放射性碘摄取最常提示甲状腺癌转移。我们回顾了15例放射性碘全身扫描，这些扫描显示了19个模拟淋巴结或脊柱转移的纵隔伪影。这些伪影在进食和饮水后的延迟图像上消失（17例），或在1周内重复检查时消失（2例），提示其起源于食管。没有患者患有临床食管或胃部疾病。只有两个伪影是线性的；12个是局灶性的，5个是弥漫性的。12个伪影在前位图像上更易观察到（上纵隔区域9个，中纵隔区域2个，下纵隔区域1个），而7个在后位图像上更易观察到（上纵隔区域2个，中纵隔区域2个，下纵隔区域3个）。这15例扫描是从我们中心在24个月内进行的约1000例扫描中识别出来的。我们得出结论，放射性碘在看似正常的食管中短暂存在可能并不罕见地模拟甲状腺癌的纵隔淋巴结或脊柱转移，并且其闪烁显像表现是可变的。
