核医学与内分泌系统疾病.ppt

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1、核医学与内分泌系统疾病华中科技大学协和医院CONTENTSDiagnosis:Thyroid(TH,AbRIA,Imaging)Parathyroid(CalcitoninRIA,Imaging)Adrenal(Cortex,MedullaryImaging)Treatment:131Itreatmentforhyperthyroidism131Itreatmentforthyroidcancer131I-MIBGtreatmentforpheochromocytomaandneuroblastoma

2、PARTONECONTENTSDiagnosis:Thyroid(TH,AbRIA,Imaging)Parathyroid(CalcitoninRIA,Imaging)Adrenal(Cortex,MedullaryImaging)Treatment:131Itreatmentforhyperthyroidism131Itreatmentforthyroidcancer131I-MIBGtreatmentforpheochromocytomaandneuroblastomaFeedbackcontrol

3、ofthyroidglandfunctionHypothalamusTRHPituitaryTSHT4＆T3TissueThyroidI-ThyroidFunctionStudy1.131I甲状腺吸碘率测量2、4、24hTUR1.131I甲状腺吸碘率临床应用:甲亢的诊断甲状腺毒症的鉴别诊断甲减的辅助诊断甲状腺肿甲亢131I治疗剂量的计算及疗效预测ThyroidFunctionStudy2.过氯酸钾释放试验临床应用⑴碘有机化障碍的先天性甲减⑵慢性淋巴细胞性甲状腺炎的辅助诊断：阳性率67%ThyroidFu

4、nctionStudy3.甲状腺激素测定a)Hyperthyroidism:elevatedTHlevels;b)Hypothyroidism:decreasedTHlevels;c)Hashimotodisease:elevated→normal→decreasedTHlevels.ThyroidFunctionStudyThyroidFunctionStudy4.TSH测定5.TRH兴奋试验ThyroidFunctionStudy5.TRHStimulatingTestTSHNormalrange3

5、0min60min120minTimeDiagnosticsignificancesForhyperthyroidism：sTSH>FT3>FT4>TT3>TT4>rT3Forhypothyroidism：TRH-TSH>sTSH≥FT4>TT4>FT3>TT3ThyroidFunctionStudyCONTENTSDiagnosis:Thyroid(TH,AbRIA,Imaging)Parathyroid(CalcitoninRIA,Imaging)Adrenal(Cortex,MedullaryIm

6、aging)Treatment:131Itreatmentforhyperthyroidism131Itreatmentforthyroidcancer131I-MIBGtreatmentforpheochromocytomaandneuroblastomaThyroidImagingNormalimagingPosition:crossthetracheajustbelowthecricoidcartilage.Shape:twolobesandisthmus.Size:weighbetween15a

7、nd25g.Function:radioactivityNormalimagingThyroidImaging右叶4.1×2.0cm；左叶4.0×2.2cm。T/B=5.9Normalvariation–pyramidallobeThyroidImaging1.观察甲状腺大小、形态和整体功能状态ThyroidImaging-临床应用右叶6.4×2.5cm；左叶6.0×2.3cm。T/B=25.7。右叶4.7×2.6cm；左叶5.0×2.3cm。T/B=1.7。右叶5.1×3.4cm；左叶4.8×2.3c

8、m。T/B=3.9。2.异位甲状腺的诊断ThyroidImaging-临床应用3.甲状腺结节的功能及性质的判定高功能结节：hyperfunctioningnodule功能正常结节：normal-functioningnodule低功能结节：hypofunctioningnodule分别又称：热结节：hotnodule温结节：warmnodule冷结节：coldnoduleThyroidImaging-临床应用热结节：多见于良性甲状腺结节，如