医学精品课件:08.甲状腺显像.ppt
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1、 Thyroid Imaging Duan DongDepartment of Nuclear MedicineThe First Affiliated Hospital of Chongqing Medical UniversityClassification and principle of thyroid imagingImaging agents and their features,imaging methodsNormal and abnormal imaging Clinical application of thyroid imagingContentsThe first pa
2、rtClassification and principle of thyroid imagingThe Classification of thyroid imagingThe Classification of thyroid imagingThyroid static imagingThyroid dynamic imagingPrinciple of static thyroid imaging Administrating an agent(131I-NaI or 99mTcO4-)which can be trapped and accumulated selectively by
3、 thyroid when entering the body of patients.Certain time after administration,Detecting the r-ray emitted by radionuclides in the thyroid with certain nuclear device,then we can obtain the image of thyroid(site,morphology,size,function).Trapped by thyroid131I or 99mTcrrrrPrinciple of dynamic thyroid
4、 imaging iv administration imging agent(99mTcO4-)flow with blood in vein to heart to artery system to thyroidal artery to thyroid Detecting the r-ray emitted by radionuclides and acquire the images continually with certain nuclear device.By these images we can obtain the information of thyroids bloo
5、d-flow(speed and amount),reflecting the function of thyroidThe second partImaging agents and their futrers,imaging methodsImaging agents and their characteristicsIodine-131(131I):v Long physical half-life(8.04d)v-rays occupy 90%,r-rays only occupy 10%of its emissionv The energy of principal r-ray is
6、 high(364 Kev)v A relatively high irradiation dose to the thyroid and whole-body v Easily obtained and with lower costv Mainly be used for detecting ectopic thyroid tissue and metastasis of thyroid carcinomav The scanning must be performed at least 24h after oral 131I Iodine-123(123I):It decays by e
7、lectron capture with a r-photon(energy is 159 Kev,which is very suitable for imaging).Physical half-life is 13.27hHigh cost(produced by cyclotron)Technetium 99m(99mTc)It decays by pure r-rays(energy is 140 Kev)Short Physical half-life(6.02h)Easily obtained and lower costLower irradiation dose to the
8、 thyroid and whole-bodyDisadvantage is its non-specificity Methods of imaging1).Asking the disease history and palpating the thyroid of patients before the examination.2).Administration of radiopharmaceuticals(or imaging agents)agentsthe route of administrationThe dose of agentsthe time of imaging99
9、mTcO4-iv(as bolus)185-370MBq(5-10mci)immidiately or20-30min131I-NaIoral1.85-3.7MBq(50-100uci)or74-148MBq(2-3mci)24-72hTable 1 Comparision of two agents Static imaging is begin at certain time(30min or 24h)after administration of imaging agents.From these images,mainly obtaining the information such
10、as site,morphology,size and function of thyroid(fig 1).Fig1.Static imaging of thyroid 3).The acquisition of images.Sometimes tomographic imaging or SPET/CT images fusion is necessary to identify suspicious focus shown in planar imaging.3).The acquisition of images.Dynamic thyroid imaging is begin at
11、 the same time with intravenous administration,and acquire the images continually,2s per frame,sum to 20 frames.(Fig.2)Fig2.Dynamic imaging of thyroid Supine,neck extended,and detecting in anterior,sometimes in left or right anterior oblique posture.4).The posture of imagingFig3.posture of imagingTh
12、e third partNormal and abnormal imaging present1)The normal site of thyroid image is in the middle of neck.1.Normal static imaging(Fig 5)2)Its shape like a butterfly(have two lobes,which usually were joined by the isthmus).and sometimes the pyramidal lobe can be found in some normal people.3)The nor
13、mal size:the mean height is 4.5cm,width is 2.5cm of two lobes.4)The distribution of imaging agents should be uniform.5)If imaging agent is 99mTc,the images of salivary gland and mucosa of mouth,nasopharynx,usually can be seen.2.Abnormal Static images(1)abnormal of morphology:irregular or incomplete,
14、could be seen in multinodular goiter and congenital absence of one lobe(Fig6).(2)The abnormal of size:usually enlarge,be seen in hyperthyroid and multinodular goiter(Fig7).(3)The abnormal of site:seen in ectopic thyroid,the image of thyroid may occur in the base of tongue,or sublingual,or substernal
15、,even in the pelvis(Fig8).(4)The abnormal of distributionvThe radioactivity was diffuse increased in the whole thyroid(seen in hyperthyroid).Fig9.vThe radioactivity was diffuse decreased in the whole thyroid(seen in hypothyroid or thyroiditis).Fig10.vThe radioactivity was focally increased or decrea
16、sed in the thyroid(seen in thyroid nodules),we define it by the relative amount of radioactivity present as follows:Hot nodule:higher than normal tissue(Fig11)cool or cold nodule:lower than normal tissue or no(Fig12)warm nodule:equal to normal tissue(Fig13)3.Normal dynamic imaging(Fig4.)8-12s after
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