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Incidental thyroid uptake during 99mTc-methylene diphosphonate bone scintigraphy in oncologic patients 肿瘤患者99mtc -二膦酸亚甲基骨显像期间偶然的甲状腺摄取
IF 0.3 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2019-01-01 DOI: 10.18502/IRJNM.V27I1.974
Stojanoski Sinisa, Manevska Nevena, Jovanovska Anamarija
Introduction: Extraosseous accumulation of 99mTc – methylene diphosphonate (MDP) may be due to neoplastic, dystrophic, hormonal, inflammatory, ischemic, traumatic or excretory disorders. 99mTc-MDP incidental thyroid uptake is not frequent and is possibly caused by the presence of dystrophic or metastatic calcification, biopsy procedure and presence of benign or malignant thyroid nodules. To analyze the etiological factors leading to 99mTc-MDP uptake in the thyroid gland. Methods: Fifty patients (pts), 19 females (38%) and 31 males (62%), 62±12 years, with no pervious history of thyroid disease, were included in the study. In the period January 2016 – January 2018, all pts underwent MDP bone scintigraphy due to oncologic indication and incidental tracer uptake was noted in the region of the thyroid gland. Ultrasonography (US) was performed in all pts. Patients with detected nodules underwent 99mTc-pertechnetate scintigraphy and fine needle aspiration cytology (FNAC). Thyroid hormone and autoantibodies levels were also analyzed. SPECT/CT procedure was performed in all patients to precisely localize the MDP uptake. Results: Thirty-nine patients had calcifications in the thyroid gland (29 with microcalcifications and 10 with macrocalcifications). In 23 patients, thyroid nodules were detected. 99mTc-pertechnetate scintigraphy presented 15 cold nodules and 8 nodules with increased tracer uptake. FNAC in 3 patients presented nuclear anisocariosis, with Hurthle cell metaplasia, and surgery was advised. In 11 patients, thyroid cartilage calcifications were detected. Conclusion: Incidental findings of thyroid 99mTc-MDP accumulation during bone scintigraphy indicate presence of additional, previously unexpected, active disease processes.
99mTc -亚甲基二膦酸盐(MDP)的骨外积累可能是由于肿瘤、营养不良、激素、炎症、缺血、创伤或排泄障碍。99mTc-MDP偶发甲状腺摄取并不常见,可能由营养不良或转移性钙化、活检程序和良性或恶性甲状腺结节的存在引起。分析99mTc-MDP在甲状腺摄取的病因。方法:患者50例,女性19例(38%),男性31例(62%),年龄62±12岁,既往无甲状腺疾病史。在2016年1月至2018年1月期间,由于肿瘤指征,所有患者都接受了MDP骨显像,并在甲状腺区域发现了偶然的示踪剂摄取。所有患者均行超声检查(US)。检测到结节的患者行99mtc显像和细针吸细胞学检查(FNAC)。甲状腺激素和自身抗体水平也进行了分析。所有患者均行SPECT/CT检查以精确定位MDP摄取。结果:39例甲状腺发生钙化,其中微钙化29例,大钙化10例。23例患者检出甲状腺结节。99mtc高显像显示15个冷结节和8个示踪剂摄取增加的结节。3例FNAC患者出现核异体病伴Hurthle细胞化生,建议手术治疗。11例患者甲状腺软骨出现钙化。结论:在骨显像中偶然发现的甲状腺99mTc-MDP积累表明存在额外的,以前意想不到的,活跃的疾病过程。
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Iranian Journal of Nuclear Medicine
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