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Annals of Nuclear Medicine and Molecular Imaging

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篇名 鎝-99m甲狀腺核子醫學造影先天性甲狀腺低能症之應用
卷期 12:2
並列篇名 The Application of [fee6]Tc Thyroid Scintigraphy in Congenital Hypothyroidism
作者 林佳輝洪光威王世楨
頁次 55-59
關鍵字 甲狀腺核子造影先天性甲狀腺低能症Thyroid scanCongenital
出刊日期 199906

中文摘要

前言:小兒甲狀腺先天性發育異常包括甲狀腺缺如、異位、體積較小或腫大等,這些發育異常會造成甲狀腺功能不同程度地減低。利用放射性同位素造影可對這些情況作出判斷。
方法:本研究收集本院在1989~1998之10午間,經由新生兒篩檢確定為先天性甲狀腺低能症167例,包括男90例、女77例,平均月齡2.4(1~5)個月,每個個案在未予治療前,以放射免疫分析測定血清TSH和Free T4的濃度,評估甲狀腺功能,並施予鎝-99m甲狀腺核子造影以鑑別診斷病因。
結果:在167例先天性甲狀腺低能症當中,正常位置甲狀腺有93例(男:女=58:35),有2例只有一邊有甲狀腺(男:女=2:0),未顯影者有10例(男:女=3:7),異位甲狀腺有27例(男:女=7:20),輕度腫大有12例(男:女=6:6),明顯腫大有23例(男:女=14:9)。
結論:大部份的先天性甲狀腺低能症,可由甲狀腺核子造影及血清TSH、Free T4,獲得鑑別診斷,對於預後、治療的方針及流行病學研究皆有幫助。甲狀腺核子造影不但能夠清楚顯示甲狀腺位置、型態、大小,還可以反映腺體功能,有助於選擇治療方案,因此不失為一種簡便、安全的方法。

英文摘要

Background: Congenital abnormalities of neonatal thyroid gland include athyrosis, ectopia, and developmental defects (enlargement / agenesis of the thyroid gland). All of them may induce hypothyroidism at different levels. Technetium-99m pertechnetate thyroid scans are generally applied to neonates with congenital hypothyroidism.
Methods: We reviewed the thyroid images of 167 neonates who were diagnosed to have congenital hypothyroidism by neonatal TSH and free T4 screening in recent 10 years in VGHTC.
Results: Of these, 93 cases were of normal size and location (M:F = 58:35); 2 cases, both male, were hemiagene- sis; 10 cases were athyrosis (M:F = 3:7); 27 cases were ectopic thyroid (M:F = 7:20); 12 cases were found with mild enlargement (M:F = 6:6), and 23 cases with obvious enlargement (M:F = 14:9). Differential diagnosis can be estab- lished in most cases of congenital hypothyroidism by thyroid scan, serum TSH and free T4.
Conclusion: We concluded that 99mTc thyroid scan is recommendable not only because it is convenient and safe in the differential diagnosis of congenital hypothyroidism but also because it provides accurate information on thyroid function which helps treatment.

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