Zorunlu İyodinasyon Sonrası Multinodüler Guatr Hastalarının Tiroid Fonksiyonları, İdrar İyot Düzeyleri, Tc99m Perteknetat Uptake?leri, I-131 Uptake?leri Arasındaki İlişki

Öz

Amaç: Çalışmada amaç, 1. multinodüler guatr hastalarında MNG idrar iyot düzeyleri ile tiroid Tc99m perteknetat uptake TcPU düzeyleri arasındaki ilişkiyi belirlemek, 2. ötiroid, klinik ve subklinik hipertiroidi hasta gruplarında TcPU düzeylerinin değerlendirmek, 3. TcPU ile I-131 uptake düzeylerini karşılaştırarak TcPU’in I-131 uptake yerine kullanılıp kullanılamayacağını belirlemektedir.Gereç ve Yöntemler: Çalışmaya yeni tanı almış MNG olan 29 hasta dahil edildi. Hastalardan kan ve idrar örnekleri alındıktan sonra TcPU ve tiroid sintigrafisi yapıldı. I-131 uptake ölçümleri yapılarak 4. ve 24. saat uptake değerleri ölçüldü. Bulgular: Yirmi bir hastanın %72 idrar iyot düzeyi yeterli iyot alımını gösteren 100 μg/g kreatinin’den yüksek idi. TcPU düzeyleri ile idrar iyot düzeyleri arasında negatif korelasyon saptandı. TSH düzeylerine göre 18 hasta ötiroid, 11 hasta hipertiroid idi. TcPU düzeyleri hipertiroid hastalarda ötiroid olanlardan yüksekti fakat istatistiksel anlamlı değildi. TcPU düzeyleri ile I-131 4. saat ve 24. saat uptake’leri arasında pozitif korelasyon saptandı. Sonuç: Daha pratik bir yöntem olan TcPU değerleri I-131 uptake yerine kullanılabilir. Zorunlu iyodinasyon sonrası MNG hastalarında idrar iyot düzeyleri ile TcPU düzeyleri arasındaki ilişki daha geniş hasta serilerinde değerlendirilmelidir

Anahtar Kelimeler

• Tc99m perteknetat, Tiroid fonksiyon testleri, Nodüler guatr

Correlation of Thyroid Functions, Urinary Iodine Excretion, Tc99m Pertechnetate and I-131 Uptakes in the Patients with Multinodular Goiter After Mandatory Iodinization

Abstract

Objective: The aims of this study are first to evaluate the association between urine iodine levels and thyroid Tc99m pertechnetate uptake TcPU levels in multinodular goiter MNG patients, second to evaluate TcPU levels in euthyroid, subclinical and clinical hyperthyroid patient groups, and third to compare TcPU and I-131 uptake levels to decide whether TcPU can be use instead of I-131 uptake.Material and Methods: Twenty-nine patients who were newly diagnosed multinodular goiter were included in the study. After taking blood and urine samples, TcPU tests and thyroid scintigraphies were done. By performing I-131 uptake measurements 4th and 24th hour uptake levels were calculated.Results: Twenty-one patients 72% had a urinary iodine level above 100 μg/g creatinine that indicates sufficient iodine intake. There was a significant negative correlation between TcPU levels and urine iodine levels. According to TSH levels, while 18 patients were euthyroid, 11 were hyperthyroid. The TcPU levels were found to be higher in hyperthyroid patients compared to the euthyroid ones, but this difference was not statistically significant. There was a significant positive correlation between the patients’ TcPU and I-131 4th and 24th hour uptake values.Conclusion: TcPU, which is a more practical method, can be used instead of I-131 uptake values. Our results suggest that it would be important to evaluate the relationship between urinary iodine and TcPU levels in larger series of MNG patients after mandatory iodinization

Keywords

• Tc99m pertechnetate, Thyroid function tests, Nodular goiter

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