| Objective: This study examines the relationship between urinary iodine level and thyroid technetium-99 m uptake in patients with Graves,hyperthyroidism Methods: We collected patients diagnosed with Graves,hyperthyroidism from July 10 of2018 to November 30 of 2018 in the first affiliated hospital of china medical university.All patients underwent technetium-99 m thyroid scintigraphy.Before the examination all patients underwent interrogation and palpation.All patients' urine samples were collected used for the determination of urinary iodine concentration and urinary creatinine concentration(urinary creatinine concentration was used for revise urinary iodine concentration),urinary iodine concentration and urinary creatinine concentration were determined by ICP-MS method and enzymatic method respectively.All patients underwent technetium-99 m thyroid scintigraphy,and techniques for ROI were applied to draw thyroid and regional cervical soft tissues,to record the number of radioactive counting of thyroid(T)and regional Cervical soft tissues(C),and to calculate T/C ratio.T/C ratio was used to define the level of thyroid technetium uptake.The ratio of urinary iodine concentration to urinary creatinine concentration in random urine samples was used as the corrected urinary iodine level(?g/gCr).All patients' corrected urinary iodine and thyroid technetium-99 m uptake were analyzed by correlation.According to the corrected urinary iodine concentration(urinary iodine/urinary creatinine(?g/gCr))the patients were divided into three groups: low urinary iodine level group: corrected urinary iodine concentration?100?g/gCr;middle urinary iodine level Group:corrected urinary iodine concentration 101-249?g/gCr;high urinary level group:corrected urinary iodine concentration?250?g/gCr.The thyroid technetium-99 m uptake of the three group patients was statistically analyzed.According to interrogation of the patients,diet,The patients were divided into two groups,Seafood intake group:The patients eaten sea food just like kelp,nori,marine fish in two weeks before the examination;No seafood intake group: Patients without a consumptions of seafood.Compare the two groups of patients,urinary iodine and the uptake of technetium-99 m.The correlation among urinary iodine and the thyroid technetium-99 m uptake was analyzed by Pearson correlation test,p<0.05 was considered as statistically significant.One-way ANOVA was used to compare the differences between the multi-group,and LSD was used for multiple comparisons,p<0.05 was considered statistically significant.The two-sample T test was used to assess the the significance of differences in the data satisfy the variance homogeneity of normal distribution,p<0.05 was considered as statistically significant.The Mann-witney U test was used to assess the significance of differences in the data do not satisfy the variance homogeneity of normal distribution,p<0.05 was considered as statistically significant.Results: 110 patients were collected,among them,10 patients were excluded from the group because they did not choose the machine-acquired image or the image showed the uneven distribution or defect of thyroid imaging agent in the experiment,and a total of100 patients were finally included in the group.Thyroid scan images of all patients indicated that the thyroid gland was in normal position and consistent with Graves,hyperthyroidism images.There were 100 enrolled patients,including 20 males and 80 females,with an average age of 40.33±11.85 years.There were 10 patients in the low urinary iodine level group,including 7 males and 4 females,with an average age of38.5±10.02 years.There were 61 patients in the middle urinary iodine level group,including 13 males and 48 females,with an average age of 40.33±13.01 years.There were 29 patients in the group with high urinary iodine level,They were all female patients,with an average age of 40.97±10.00 years.There were 31 patients in the seafoods intake group,including 4 males and 27 females,with an average age of37.74±10.09 years.Sixty-nine patients including 16 males and 53 females in the no seafoods intake group with an average age of 41.49±12.50 years.The adjusted urinary iodine levels and T/C ratios were 129.56±43.87(?g/gCr)and 22.76±8.49 for male patients,and 269.51±300.17(?g/gCr),18.66±5.92 for female patients,respectively.The urinary iodine level of male patients was lower than that of female patients,and the difference was statistically significant(t=-2.12,p<0.05).The T/C ratio of male patients was higher than that of female patients,and the difference was statistically significant(t=2.97,p<0.05).Urinary iodine level and T/C ratio of all patients were: 240.80±275.01(?g/g Cr)and 19.66±6.88,respectively.Urinary iodine concentration was negatively correlated with T/C ratio in 100 patients(r=-0.24,p<0.05).The technetium-99 m uptake was 24.18±8.43 in patients with low urinary iodine level.The thyroid technetium-99 muptake was 20.35±6.93 in the middle urinary iodine level group.The thyroid technetium-99 m uptake was 16.81±4.94 in patients with high urinary iodine level,and the difference was statistically significant in patients with different urinary iodine level(F=5.4,p<0.01).The pairwise comparison between the three groups indicated that the The thyroid technetium-99 m uptake of patients in the low urinary iodine level group was higher than that in the high urinary iodine level group,with statistical difference(t=3.05,p<0.01).The thyroid technetium-99 m uptake of patients in the middle urinary iodine level group was significantly higher than that in the high urinary iodine level group(t=2.38,p<0.05).The thyroid technetium-99 m uptake of patients in the low urinary iodine level group was higher than that in the middle urinary iodine level group,with no statistical difference(t=1.70,p>0.05),and The thyroid technetium-99 m uptake in the patients with increased urinary iodine concentration showed a downward trend.In the seafood intake group,adjusted urinary iodine level of patients was 229.20(163.06,400.16)?g/gCr.In the no seafood group,adjusted urinary iodine level of patients was 178.97(118.86,245.54)?g/gCr.The adjusted urinary iodine level of seafood intake group was higher than that of no seafood intake group,and the difference was statistically significant(Z=2.87,p<0.01).The T/C ratio of patients in the seafood intake group was :(16.65±6.41).The T/C ratio of the patients in on seafood intake group was: 21.03±6.73.The T/C ratio of the patients in seafood group was lower than that in no seafood intake group,and the difference was statistically significant(T =3.10,p<0.01).Conclusions: The urinary iodine level of patients with Graves,hyperthyroidism was negatively correlated with their thyroid technetium-99 m uptake and with the increase of urinary iodine level,their thyroid technetium uptake might be inhibited.Patients with Graves,hyperthyroidism eaten seafood before technetium-99 m thyroid scintigraphy in two weeks their urinary iodine level will rise further inhibit the uptake of Technetium-99 m.Patients with Graves,hyperthyroidism should avoid eating seafood before thyroid technetium imaging,so it is necessary to survey patients about their recent diet.When conditions permit,urine iodine can be measured in patients to accurately assess the level of iodine nutrition in patients,determine whether patients are suitable for examination. |
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