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[Blood tests and imaging in thyroid pathology].

P Bergmann1, M Cannie

  • 1Services de Diagnostic et de Traitement par Isotopes, C.H.U. Brugmann, Bruxelles. pbergman@ulb.ac.be

Revue Medicale De Bruxelles
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PubMed
Summary

Thyroid function tests like TSH, FT4, and FT3 are crucial for diagnosing and monitoring thyroid disorders. Antibody measurements and imaging techniques like echography and scintigraphy aid in specific diagnoses and cancer follow-up.

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Area of Science:

  • Endocrinology
  • Nuclear Medicine
  • Radiology

Background:

  • Thyroid function is primarily assessed using TSH, FT4, and FT3 levels.
  • TSH is a reliable first-line diagnostic but less precise for treatment monitoring.
  • Antibodies and imaging are essential for specific thyroid disease diagnoses and management.

Purpose of the Study:

  • To outline the diagnostic and monitoring roles of various circulating analytes and imaging techniques in thyroidology.
  • To clarify the utility of TSH, free thyroid hormones, antibodies, and thyroglobulin in different clinical scenarios.
  • To emphasize the importance of echography and scintigraphy in evaluating thyroid morphology and function.

Main Methods:

  • Review of circulating analytes including TSH, FT4, FT3, anti-TPO, TSI, and thyroglobulin.
  • Description of imaging modalities: echography, thyroid scintigraphy (99mTc), and whole-body scintigraphy (131I).
  • Correlation of laboratory and imaging findings with specific thyroid conditions and treatment follow-up.

Main Results:

  • Normal TSH reliably excludes thyroid dysfunction; free hormones are vital for treatment follow-up.
  • Anti-TPO and TSI measurements diagnose autoimmune thyroiditis and Graves' disease, respectively.
  • Thyroglobulin is key for differentiated thyroid cancer surveillance post-treatment; echography and scintigraphy provide morphological and functional insights.

Conclusions:

  • A combination of biochemical markers and imaging is essential for comprehensive thyroid evaluation and management.
  • TSH, free hormones, antibodies, thyroglobulin, echography, and scintigraphy play distinct, indispensable roles.
  • Accurate interpretation of these tests guides diagnosis, treatment monitoring, and prognosis in thyroid disorders.