^99mTcO4-动态显像对亚急性甲状腺炎临床诊断价值

目的探讨甲状腺^99mTcO4-动态显像对亚急性甲状腺炎（亚甲炎）的临床诊断价值。方法对37例经临床证实的亚甲炎病人行^99mTcO4-动态显像,根据就诊时血清FT3、FT4水平分为甲状腺功能亢进（甲亢）期组（25例）和甲状腺功能减退（甲减）期组（12例）;依显像后甲状腺单叶或双叶显像异常分为单叶显像异常组（11例）和双叶显像异常组（26例）,分别对其动态显像中的血流相、血池相和延迟相结果进行分析。结果 11例单叶显像异常和26例双叶显像异常的亚甲炎病人血流相、血池相和延迟相显像结果差异无统计学意义（P〉0.05）;25例甲亢期和12例甲减期亚甲炎病人血流相、血池相和延迟相显像结果差异有显著性（P=0.00～0.03）,甲亢期甲状腺血流灌注相多表现为血流灌注增强（13/25）,血池丰富（17/25）;延迟相甲状腺轮廓不清、放射性分布明显稀疏（18/25）。甲减期动态显像多表现为血流灌注减低（7/12）,血池减少（9/12）;延迟相甲状腺隐约显影、局部明显稀疏、缺损（9/12）。结论 ^99mTcO4-动态显像不仅能反映亚甲炎病人的甲状腺血流灌注情况,还可判断甲状腺受累的程度和范围及功能变化,有助于亚甲炎的临床诊断。

CLINICAL VALUE OF RADIONUCLIDE DYNAMIC IMAGING IN THE DIAGNOSIS OF SUBACUTE THYROIDITIS

Objective To assess the clinical value of radionuclide dynamic imaging（RDI） in the diagnosis of subacute thyroiditis（ST）. Methods Thirty-seven patients with ST confirmed clinically were divided into two groups,hyperthyroidism stage（group 1,25 cases） and hypothyroidism stage（group 2,12cases）,based on their serum levels of FT3 and FT4 at the time of visit.They were then divided again into one-lobe abnormal（OLA） group（11 cases） and two-lobe abnormal（TLA） group（26 cases） according to either abnormal imaging seen in one lobe or two lobes of the gland.The blood flow phase（BFP）,blood pool phase（BPP） and lag phase（LP） were analysed. Results The differences of BFP,BPP and LP between OLA and TLA groups were not statistically significant（P0.05）,while that between group 1 and group 2 were significant（P=0.00-0.03）.In group 1,BLP appeared as boost blood perfusion（13/25）,abundant blood pool（17/25）;unclear outline of the thyroid（18/25）,and rarefaction of radioaction（18/25） in LP.In group 2,the imaging appeared as lower blood perfusion（7/12）,decreased blood pool（9/12）;ambiguous image of the gland,local sparseness and defect in LP（9/12）. Conclusion RDI reflects not only blood perfusion of the thyroid gland of patients with ST,but can also be used for the judgement of the degree and extent involved in the gland,which is conducive to a diagnosis of subacute thyroiditis.