Wen C, Iuanow E, Oates E, Lee S L, Perrone R
Department of Radiology, New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
J Nucl Med. 1998 Dec;39(12):2158-61.
Sensitive and specific, whole-body 131I scintigraphy remains an important technique for diagnosing metastases from differentiated papillary or follicular thyroid carcinoma. False-positive 131I localization is well recognized and can occur in a variety of conditions. We present a case of intense 131I localization in a previously unsuspected large renal cyst; the lesion was not visualized on routine preablation diagnostic 131I scintigraphy but was obvious on post-therapeutic whole-body imaging, underscoring the value of post-therapy imaging in detecting abnormalities not apparent on diagnostic studies. Radioiodine within the urinary bladder or, at times, the renal collecting system is expected, because 131I excretion is primarily by glomerular filtration. In the case presented here, 131I activity within the renal cyst supports the concept that iodide is subject to an active secretory process by the renal tubule.
灵敏且特异的全身碘-131闪烁扫描术仍然是诊断分化型乳头状或滤泡状甲状腺癌转移灶的一项重要技术。碘-131定位的假阳性情况已得到充分认识，且可发生于多种情形。我们报告一例之前未被怀疑的巨大肾囊肿出现强烈碘-131摄取的病例；该病灶在常规消融前诊断性碘-131闪烁扫描中未显影，但在治疗后全身显像中却很明显，这突出了治疗后显像在检测诊断性检查中未显现异常方面的价值。膀胱内或有时肾集合系统内出现放射性碘是预料之中的，因为碘-131主要通过肾小球滤过排泄。在本文所呈现的病例中，肾囊肿内的碘-131活性支持了碘化物受肾小管主动分泌过程影响这一概念。
