Akçay G, Uslu H, Varoglu E, Tekin S B, Gündogdu C
Division of Endocrinology, Department of Internal Medicine, University of Atatürk, Erzurum, Turkey.
Br J Clin Pract. 1997 Jan-Feb;51(1):5-7.
Thyroid nodularity is a common finding. The incidence of thyroid cancer in the general population is estimated at 0.1%. Thyroid nodules are evaluated by palpation, ultrasonography, radionuclide scintigraphy and fine-needle aspiration cytology. Routine thyroid scintigraphy is made by using Tc-99m-pertechnetate or the I-131 and I-123 scintigraphic method. Tc-99m-tetrofosmin accumulates in the myocardium, skeletal muscle, liver, spleen breast tissue, kidney and normal and pathological thyroid tissue. We investigated 36 patients (28 females and 8 males) with solitary and/or multiple thyroid nodules. All the patients were euthyroid, and their thyroid nodules were diagnosed by palpation and ultrasound examination. Thyroid scintigraphy was applied by Tc-99m-pertechnetate, then thyroid fine-needle aspiration biopsy was performed. Finally, Tc-99m-tetrofosmin scintigraphy was carried out. Five patients (14.8%) had differential thyroid carcinoma, 23 (63.8%) had thyroid adenoma, 1 (0.02%) had Riedel's thyroiditis and 7 (19.4%) had follicular cyst. We detected 80% uptake in the early phase and 100% in the late phase by Tc-99m-tetrofosmin scintigraphy in the differentiated thyroid carcinoma group. In summary, we claim that Tc-99m-tetrofosmin may be an important scintigraphic method to identify thyroid malignancy from benign thyroid pathologies.
甲状腺结节是一种常见的表现。普通人群中甲状腺癌的发病率估计为0.1%。甲状腺结节通过触诊、超声检查、放射性核素闪烁扫描和细针穿刺细胞学检查进行评估。常规甲状腺闪烁扫描采用锝-99m高锝酸盐或碘-131和碘-123闪烁扫描法。锝-99m替曲膦聚集在心肌、骨骼肌、肝脏、脾脏、乳腺组织、肾脏以及正常和病变的甲状腺组织中。我们对36例（28例女性和8例男性）患有单个和/或多个甲状腺结节的患者进行了研究。所有患者甲状腺功能正常，其甲状腺结节通过触诊和超声检查确诊。采用锝-99m高锝酸盐进行甲状腺闪烁扫描，然后进行甲状腺细针穿刺活检。最后，进行锝-99m替曲膦闪烁扫描。5例（14.8%）患有分化型甲状腺癌，23例（63.8%）患有甲状腺腺瘤，1例（0.02%）患有Riedel甲状腺炎，7例（19.4%）患有滤泡囊肿。在分化型甲状腺癌组中，通过锝-99m替曲膦闪烁扫描，我们在早期检测到80%的摄取，在晚期检测到100%的摄取。总之，我们认为锝-99m替曲膦可能是一种从良性甲状腺病变中识别甲状腺恶性肿瘤的重要闪烁扫描方法。
