Effect of Lugol's iodine on the vascularity of thyroid gland in hyperthyroidism

Vascularity of the thyroid gland was measured in twenty thyrotoxic patients (including Graves and multinodular goitres) and eight normal subjects by a new objective parameter--'Thyroid Vascularity Index' (TVI). The TVI was calculated by comparing the areas under the normalized thyroid and carotid artery curves up to the time of peak of the arterial curve caused by the first passage of a radioactive bolus. Compared to normal thyroid, all the toxic goitres had increased TVI (p less than 0.001); it being maximum in Graves disease (p less than 0.05). TVI in Graves disease was not affected by carbimazole therapy but decreased dramatically in eight out of ten patients (p less than 0.01) two weeks after Lugol's iodine was added. There was a sustained fall in TVI in all the ten patients (p less than 0.001) with chronic iodine therapy up to six weeks without any hormonal escape. TVI in multinodular goitres showed no significance change with carbimazole or iodine therapy.     

Gallium uptake in cerebrotendinous xanthomatosis

In a patient with cerebrotendinous xanthomatosis, a rare familial sterol storage disease, increased uptake of gallium-67 was observed in the tendon xanthomas. This is considered to have resulted from the tumour-like proliferation of histiocytic cells in the xanthomas. Abnormalities in the white matter of the cerebellum and the brain stem observed by X-ray computed tomography and magnetic resonance imaging were not detected by⁶⁷Ga scintigraphy, possibly due to the small size of the CNS lesions.     

甲状腺本身病变所致甲亢的核素显像特征

目的甲状腺功能亢进症具有多种病因、临床表现和治疗方法。应用核素显像对甲状腺自身病变所致甲状腺功能亢进症病因进行正确的诊断,指导选择相对应合适的治疗方法。方法319例临床拟诊甲亢患者,治疗前进行甲状腺显像（thyroid radionuclide imaging）,对甲亢病因做分型。结果甲状腺显像特征分类Grave’s病（GD）259例（合并结节66例）,81．2％;毒性腺瘤（TA）36例,11．3％;毒性多结节性甲状腺肿（TMNG）9例,2．8％;亚急性甲状腺炎15例,4．7％。结论甲状腺核素显像在甲状腺功能亢进症的分类和指导治疗中起重要的基础作用,可为临床提供合理及最佳的临床实践。     

Gallium uptake in tryptophan-related pulmonary disease

We describe a patient who developed fever, fatigue, muscle weakness, dyspnea, skin rash, and eosinophilia after taking "high doses" of tryptophan for insomnia for two years. A gallium-67 scan revealed diffuse increased uptake in the lung and no abnormal uptake in the muscular distribution. Bronchoscopy and biopsy confirmed inflammatory reactions with infiltration by eosinophils, mast cells, and lymphocytes. CT scan showed an interstitial alveolar pattern without fibrosis. EMG demonstrated diffuse myopathy. Muscle biopsy from the right thigh showed an inflammatory myositis with eosinophilic and lymphocytic infiltrations.     

Effect of reserpine on salivary gland radioiodine uptake in thyroid cancer

Nine patients with thyroid cancer were treated with reserpine in an attempt to reduce radiation exposure to the salivary glands from 100-150 mCi doses of I-131 therapy to thyroid remnants or metastases. Three control patients were not treated with reserpine but did receive 100-150 mCi of I-131. Parotid/background ratios of activity after radioablative doses of I-131 in patients not treated with reserpine were significantly higher than the patients treated with reserpine, and this was also true seven days after the radioablative dose. Combined therapy with reserpine, chewing gum, lemon candies, and hydration is suggested for the prevention of sialadenitis and xerostomia due to large doses of radioiodine.     

Clinical significance of diffusely increased 18F-FDG uptake in the thyroid gland.

Our purpose was to determine the clinical significance of diffusely increased (18)F-FDG uptake in the thyroid gland as an incidental finding on PET/CT. METHODS: All patients who were found to have diffuse thyroid uptake on (18)F-FDG PET/CT in our institution between November 2004 and June 2006 were investigated and compared with an age- and sex-matched control group. The (18)F-FDG uptake in the thyroid was semiquantified using maximum standardized uptake value and correlated to the available serum thyroid-stimulating hormone (TSH) and thyroid peroxidase (TPO) antibody levels using regression analysis. RESULTS: Of the 4,732 patients, 138 (2.9%) had diffuse thyroid uptake. Clinical information was available for 133 of the 138 patients. Sixty-three (47.4%) had a prior diagnosis of hypothyroidism or autoimmune thyroiditis, of whom 56 were receiving thyroxine therapy. In the control group, consisting of 133 patients with no thyroid uptake, there were 13 (9.8%) with a prior diagnosis of hypothyroidism, 11 of whom were receiving thyroxine therapy. In the study group, 38 (28.6%) of 133 patients did not undergo any further investigation for thyroid disease, whereas 32 (24.1%) of 133 patients were examined for thyroid disease after PET. Nineteen were found with autoimmune thyroiditis or hypothyroidism, and replacement therapy was initiated in 12. No significant correlation was found between maximum standardized uptake value and TSH (P = 0.09) or TPO antibody (P = 0.68) levels. CONCLUSION: The incidental finding of increased (18)F-FDG uptake in the thyroid gland is associated with chronic lymphocytic (Hashimoto's) thyroiditis and does not seem to be affected by thyroid hormone therapy. SUV correlated neither with the degree of hypothyroidism nor with the titer of TPO antibodies.     

The thyroid gland with low uptake lesions: evaluation by ultrasound

An ultrasound examination was performed in 401 patients who had isotopically cold, solitary lesions of the thyroid gland. Of the parameters studied, the level of echoes was the most useful in making the sonographic diagnosis: the rate of malignancy was extremely low both in hyperechoic and echo-free lesions. The presence of a peripheral, complete "halo" appeared to be helpful in differentiating benign lesions from malignant lesions. Approximately 20-25% of the lesions thought to be solitary on the radionuclide study were found to be multinodular on US. When fine-needle aspiration biopsy was used with US the need for surgical exploration of the thyroid gland was obviated in selected cases.