Reinhardt M J, Moser E
Department of Nuclear Medicine, Albert-Ludwigs-University, Freiburg i.Br., Germany.
Eur J Nucl Med. 1996 May;23(5):587-94. doi: 10.1007/BF00833398.
Iodine deficiency and iodine-deficiency disorders continue to be problems in several parts of Europe, requiring further improvements in the techniques employed in thyroid diagnosis, and particularly in the early diagnosis and risk assessment of autonomously functioning thyroid tissue. For the latter purpose, scintigraphy with technetium-99m pertechnetate under exogenous or endogenous thyroid-stimulating hormone (TSH) suppression provides the best results. Significant methodological improvements in laboratory tests have resulted from the application of new luminescent techniques and gene technology to thyroid function tests. Especially TSH measurement using second- or third-generation assays ensures diagnostic accuracy, so that the thyrotropin-releasing hormone (TRH) test is now almost always unnecessary. The differentiation of blocking and stimulating TSH receptor antibodies is relevant when discrepant results are obtained with respect to thyroid function. Determination of glycosaminoglycans in urine may become a helpful tool in the follow-up of endocrine ophthalmopathy. Some new imaging agents have recently been applied in the scintigraphy of thyroid diseases, such as octreotide, or in thyroid diagnosis, such as fluorodeoxyglucose. Both improve the detectability of metastases of thyroid cancer, especially if the radioiodine scan is negative.
碘缺乏及碘缺乏症在欧洲的多个地区仍然是问题，这需要进一步改进甲状腺诊断技术，尤其是自主功能性甲状腺组织的早期诊断和风险评估技术。对于后一目的，在外源性或内源性促甲状腺激素（TSH）抑制下使用高锝[99mTc]酸盐进行闪烁扫描可提供最佳结果。将新的发光技术和基因技术应用于甲状腺功能测试，使得实验室检测有了显著的方法学改进。尤其是使用第二代或第三代检测方法测定TSH可确保诊断准确性，因此促甲状腺激素释放激素（TRH）试验现在几乎已无必要。当甲状腺功能检测结果出现差异时，区分阻断性和刺激性TSH受体抗体具有重要意义。尿中糖胺聚糖的测定可能成为内分泌性眼病随访中的有用工具。一些新型显像剂最近已应用于甲状腺疾病的闪烁扫描，如奥曲肽，或用于甲状腺诊断，如氟脱氧葡萄糖。两者都提高了甲状腺癌转移灶的可检测性，尤其是在放射性碘扫描呈阴性时。
