Alonso O, Mut F, Lago G, Aznarez A, Núñez M, Cánepa J, Touya E
Nuclear Medicine Centre, Clinical Hospital of the University of Uruguay, Montevideo.
Nucl Med Commun. 1998 Mar;19(3):257-61. doi: 10.1097/00006231-199803000-00010.
Diffusely reduced 99Tc(m)-pertechnetate uptake is a relatively infrequent but annoying finding that impairs evaluation of the thyroid gland. We studied 32 female patients aged 19-85 years with markedly reduced pertechnetate uptake. The following causes of reduced pertechnetate uptake were recognized: treatment with iodinated pharmaceuticals (n = 15), suppression therapy with T4 (n = 11), subacute thyroiditis (n = 5) and massive tumour replacement (n = 1). 99Tc(m)-MIBI thyroid scintigraphy was performed within 24 h of the pertechnetate study. The results were correlated with neck ultrasound, serum TSH (n = 25) and surgical findings in patients who had been operated on. The technique identified the following conditions: normally sized thyroids (n = 4), diffuse goitres (n = 8), multinodular goitres (n = 17) and solitary thyroid nodules (n = 3). Moreover, substernal goitres were identified in nine patients. This condition was confirmed at surgery in seven patients. Ultrasonography was concordant in 29 of 32 patients in terms of thyroid size and structure, but failed to demonstrate substernal thyroid tissue. Our results suggest that 99Tc(m)-MIBI scintigraphy may contribute to the diagnosis of thyroid pathology and treatment planning in patients with diffusely decreased 99Tc(m)-pertechnetate uptake.
99锝（m）-高锝酸盐摄取弥漫性降低是一种相对少见但令人困扰的发现，会影响甲状腺的评估。我们研究了32例年龄在19至85岁之间、高锝酸盐摄取明显降低的女性患者。已确认导致高锝酸盐摄取降低的以下原因：接受碘化药物治疗（n = 15）、T4抑制治疗（n = 11）、亚急性甲状腺炎（n = 5）和大量肿瘤替代（n = 1）。在高锝酸盐检查后24小时内进行了99锝（m）-甲氧基异丁基异腈甲状腺闪烁扫描。结果与颈部超声、血清促甲状腺激素（n = 25）以及接受手术患者的手术结果进行了关联。该技术识别出以下情况：甲状腺大小正常（n = 4）、弥漫性甲状腺肿（n = 8）、多结节性甲状腺肿（n = 17）和孤立性甲状腺结节（n = 3）。此外，在9例患者中发现了胸骨后甲状腺肿。7例患者在手术中得到证实。在32例患者中，29例患者的甲状腺大小和结构方面超声检查结果一致，但未能显示胸骨后甲状腺组织。我们的结果表明，99锝（m）-甲氧基异丁基异腈闪烁扫描可能有助于诊断99锝（m）-高锝酸盐摄取弥漫性降低患者的甲状腺病变并进行治疗规划。
