^(99)Tc^mO_4^-甲状腺显像定量分析的临床应用  

Clinical application of quantitative ^(99) Tc^m-pertechnetate thyroid imaging

作　　者：高永举[1] 韩建奎[2] 谢建[1] 闫新慧[1] 王杰斌[1] 朱选民[1] 刘琳[1] 孙海舟[1] 

机构地区：[1]河南省人民医院核医学科,郑州450003 [2]山东医科大学附属医院核医学科

出　　处：《中华核医学杂志》2002年第4期201-203,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨99TcmO-4甲状腺显像定量分析在甲状腺疾病诊疗中的价值。方法　采用SiemensOrbitSPECT仪对正常对照者和Graves病、桥本甲状腺炎 (HD)及亚急性甲状腺炎 (SAT)患者行99TcmO-4甲状腺动、静态双时相显像 ,测定颈动脉与甲状腺显像的时间差 (Td) ,甲状腺 5min与 1min时像素的平均放射性比值 (AR) ,2 0min时甲状腺与股中段像素的平均放射性比值 (UI)。结果　①Graves病定量分析参数与体外甲状腺功能 (简称甲功 )指标基本一致 ,治疗后UI值的恢复速度慢于Td 和AR ,亦滞后于体外甲功指标的恢复。停药后复发者的UI值高于未复发者和对照组。②HD甲功增高组的表现与Graves病相似 ,甲功正常和亚临床甲低组的Td、AR和UI值与对照组相比差异均无显著性 ,甲低组的摄99Tcm 能力降低。③SAT甲功升高者摄99Tcm 能力降低 ,多呈弥漫性放射性分布稀疏 ,甲功正常组主要表现为局限性放射性分布稀疏。结论　99TcmO-4甲状腺显像定量分析能反映甲状腺形态改变与功能变化的内在关系 。Objective To investigate the clinical value of quantitative 99 Tc m pertechnetate thyroid imaging for the diagnosis and therapeutic evaluation in patients with thyroid disease. Methods With the Siemens Orbit SPECT, 99 Tc m sodium pertechnetate thyroid imaging was performed on a control group and 108 patients with Graves' disease, 58 patients with Hashimoto's disease, 41 patients with subacute thyroiditis. Three functional parameters were calculated as follows: AR=5 min thyroid count/1 min thyroid count; UI=20 min thyroid count/thigh count; T d=imaging interval between carotid and thyroid. Results ① Three functional parameters were basically concordant with serological parameters in patients with Graves' disease. While uptake was high in patients who had contracted Graves' disease for ≤0.5 year, for those whose disease relapsed within 2 years the 99 Tc m thyroid uptake increased when the antithyroid medication was stopped. ②Thyroid images of hyperthyroid patients with Hashimoto's disease showed increased perfusion and 99 Tc m uptake, a pattern similar to that found in Graves' disease. Differences in T d, AR, UI were not significant among euthyroid, subclinical hypothyroid patients with Hashimoto's disease, so uptake ratios could indicate the thyroid activity. ③Delayed thyroid image and diffuse uptake decrease were found in hyperthyroid patients with SAT, however, focal damages were observed in euthyroid patients. Conclusion Quantitative 99 Tc m pertechnetate thyroid imaging is a significantly helpful technique in the diagnosis and treatment for common thyroid disorders.

关 键 词：^99Tc^mO4^- 临床应用 甲状腺疾病 放射性核素显像 诊断 

分 类 号：R817[医药卫生—影像医学与核医学]