Prakash R, Narayanan R V, Shankar L R, Kakar A
Department of Nuclear Medicine, Batra Hospital, New Delhi, India.
Clin Nucl Med. 1995 Oct;20(10):878-83. doi: 10.1097/00003072-199510000-00004.
Radionuclide thyroid angiography was performed in 252 patients with hypofunctioning thyroid nodules to evaluate differences in vascular flow and washout patterns in benign and malignant disease. Time activity curves of Tc-99m pertechnetate flow through the cold nodules were generated using region of interest software. Retention ratios of counts in the nodule at 2 minutes after radionuclide administration versus those at peak activity were derived. Patients subsequently underwent surgical excision and histopathologic examination. One hundred forty-four of the 204 benign nodules were avascular with absent radionuclide flow through the nodule. Fifty-six benign nodules were vascular with a prolonged radionuclide washout pattern with retention ratios ranging from 0.62-0.92. Forty-six of the 48 malignant nodules displayed increased perfusion with rapid radionuclide washout with retention ratios ranging from 0.28-0.48. Four benign nodules exhibited a similar flow and washout pattern. Radionuclide thyroid angiography with vascular flow and washout analysis appears to be a useful technique to differentiate between benign and malignant thyroid nodules with a high degree of sensitivity and specificity.
对252例甲状腺功能减退性结节患者进行放射性核素甲状腺血管造影，以评估良性和恶性疾病中血管血流和洗脱模式的差异。使用感兴趣区软件生成锝-99m高锝酸盐流经冷结节的时间-活性曲线。得出放射性核素给药后2分钟时结节内计数与峰值活性时计数的保留率。患者随后接受手术切除及组织病理学检查。204个良性结节中，144个无血管，放射性核素未流经结节。56个良性结节有血管，放射性核素洗脱模式延长，保留率为0.62 - 0.92。48个恶性结节中的46个显示灌注增加，放射性核素快速洗脱，保留率为0.28 - 0.48。4个良性结节表现出相似的血流和洗脱模式。放射性核素甲状腺血管造影及血管血流和洗脱分析似乎是一种区分良性和恶性甲状腺结节的有用技术，具有高度的敏感性和特异性。
