Refined use of scintigraphy in the evaluation of nodular thyroid disease.
Surgery
; 124(4): 656-61; discussion 661-2, 1998 Oct.
Article
em En
| MEDLINE
| ID: mdl-9780985
ABSTRACT
BACKGROUND:
Scintigraphy has been advocated in patients with a thyroid nodule when fine needle aspiration biopsy (FNAB) is not definitive. The purpose of this study was to determine the incidence of hyperfunctioning nodules in patients without a definitive FNAB, the correlation of serum thyrotropin (TSH) levels with the functional status of a nodule, and whether a sensitive TSH assay can be used in lieu of scintigraphy.METHODS:
From 1990 to 1996, patients with a thyroid nodule were evaluated with FNAB and serum TSH measurement. Iodine-123 scintigraphy was reserved for patients without a definitive FNAB and was correlated with TSH levels.RESULTS:
Of 356 patients with a thyroid nodule, 102 did not have a definitive FNAB. A hyperfunctioning nodule was diagnosed in 14 of the 102 patients. A low TSH level was detected in 12 (86%) of 14 patients with a hyperfunctioning nodule (mean = 0.04 +/- 0.38 microIU/mL) and only 20 (23%) of 88 patients with a hypofunctioning nodule (mean = 0.87 +/- 4.11 microIU/mL) (P < .05). Only 2 of 70 (2.8%) patients with a normal or increased TSH level had a hyperfunctioning nodule.CONCLUSIONS:
A 14% incidence of hyperfunctioning nodules in patients without a definitive FNAB warrants the use of scintigraphy but only when serum TSH levels are low, thus avoiding unnecessary scans in 91% of patients with a thyroid nodule.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nódulo da Glândula Tireoide
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Surgery
Ano de publicação:
1998
Tipo de documento:
Article
País de afiliação:
Estados Unidos