核子醫學-甲狀腺

  • I-131
    • 有beta射線,可用於治療
    • 也可用於RAIU (Radiation iodine update)
    • γ-ray 364KeV可用於Whole body scan,但radiation dose較高易造成star artifact,且易造成thyroid stunning (>2-4mCi)
    • 不適合thyroid scan,因為有beta射線,易thyroid stunning
    • 半衰期8天
    • 較易偵substernal goiter,有的地方先做I-123 scan看不到subternal goiter再做I-131 scan(50μCi)
    • Whole body scan 2(1.5-4) mCi
    • 治療Graves’ disease 5-15mCi,toxic nodule 20-30 mCi, ablation 30-150 mCi(>30需隔離)
    • RAIU 5-10 μCi
  • I-123
    • Thyroid scan+RAIU 200-400μCi
    • Whole body scan 1.5-2 mCi
  • Tc-99m sodium pertechnetate
    • 替代選擇
    • 因radiation dose較低,常用在小孩
    • 亦用在診斷Mechkel’s diverticulum, salivary gland
    • thyroid scan 6mCi (2-10)
  • Thyrotoxicosis
    • RAIU ↑: Hashimoto, Graves’ disease
    • RAIU -: Antithyroid drugs: propylthiouracil, Methimazole
    • RAIU ↓: Subacute thyroiditis: thyrotoxic phase, 人工 (Thyrotoxicosis Factitia), Antihyroid drugs, Struma ovarii
  • Hypothyroid
    • RAIU ↑: Hashimoto
    • RAIU -: Hashimoto, subacute thyroiditis (recovery phase)
    • RAIU ↓: hypothyroidism
  • Euthyroid
    • RAIU ↑: Rebound after antithyroid drug withdrawal , Compensated dyshormonogenesis
    • RAIU ↓: Decompensated dyshormonogenesis

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