| Objective: To investigate the diagnostic significance of99mTcO-4SPECTimaging semi-quantitative analysis in the early subacute thyroiditis.Methods:1. Review of cases:25cases of patients clinically diagnosedwith subacute thyroiditis who were treated in our hospital from May2011to May2013were retrospectively analyzed, including10male and5female patients, their age distribution was between21~52years, with anaverage age of (35.6±10.4) years, meanwhile,25cases of healthy peoplewho underwent physical examination at hour hospital during the same timeperiod were set up as the control group, all of relevant clinical data werecollected;2. Imaging method: thyroid static imaging was performed on thetwo study groups using GE Millennium MPR/MPS SPECT;3. To obtainthe visual index of thyroid uptake (VITU), i.e. T/N ratio, the present studyanalyzed the statistical differences between the observation and controlgroups by delineation of ROIs, measurements of thyroid radioactive counts(T) and the radioactive counts (N) of surrounding tissues (cervical softtissue, ipsilateral submandibular gland and ipsilateral parotid gland), aswell as t test.4. Thyroid131I uptake was determined synchronously on the observation and control groups;5. The diagnostic value of T/N ratio andthyroid131I uptake ratio was compared in the diagnosis of early subacutethyroiditis.Results: The thyroid imaging of patients with subacute thyroiditispresented certain characteristics: thyroid imaging was unclear, uneven andasymmetric distribution of radioactivity was seen, with manifestation ofsparse localized radioactive defects ("cold nodule" like changes werepresent on part of the images), there were also some patients whosethyroids showed no exact radioactive distribution. The statistical resultsrevealed that64%of the patients had sparse radioactivity as mainmanifestation (including about18%of those with "cold nodule" likechanges), and36%had conditions not shown on the imaging. VITU, i.e.T/N ratio significantly decreased in the subacute thyroiditis patients in theobservation group compared with the normal control group, of whichthyroid/neck ratio was2.85±1.29, thyroid/submandibular gland ratio was0.96±0.39, and thyroid/parotid gland ratio1.03±0.62. Thyroid131I uptakeratio also significantly decreased for the patients with subacute thyroiditiscompared with the normal control group at the same time points (4h and24h), statistical results showed that the131I uptake ratio at4h and24hwere5.26±1.38%and9.25±2.16%, respectively.Conclusions:99mTcO-4SPECT imaging is an imaging method whichemphasizes the functions of the organ or tissue under test. When it is used for thyroid static imaging, not only the location, size and shape of thyroidtissues can be accurately reflected, but the range of thyroid tissues affectedby the inflammation and their severity in the early phase of subacutethyroiditis can also be shown. The semi-quantity of VITU, i.e. T/N ratio(taking thyroid/submandibular gland as the standard) decreasedsignificantly compared with the normal control group in the early phase ofsubacute thyroiditis, which had "separation" of "hyperthyroidism" assuggested by the thyroid serological indicator similar to the conventionalthyroid131I uptake. However, due to its simple, fast, accurate and reliableoperation, the internal radioactive dose of99mTcO-314is much less than1I.Compared with thyroid131I uptake, the determination of T/N ratio does notrequire special pre-examination preparations, and the results are lessinfluenced by interfering factors, therefore, the use of99mTcO-4SPECTimaging semi-quantitative analysis as a sensitive indicator in the diagnosisof early subacute thyroiditis is of great diagnostic significance to the earlydiagnosis of subacute thyroiditis. |
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