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Hyperthyroidism with or without pyramidal lobe Graves' disease or disseminated autonomously functioning thyroid

R Wahl¹, U Müh, E Kallee

¹Medizinische Klinik und Poliklinik, Department IV, Eberhard-Karis-Universitaet, Tuebingen, Germany.

Clinical Nuclear Medicine

|July 1, 1997

Summary

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Thyroid scintigraphy using I-123 can detect specific gland vestiges like the pyramidal lobe. These findings help diagnose autoimmune hyperthyroidism, Graves

Area of Science:

Nuclear Medicine
Endocrinology
Radiology

Background:

Thyroid gland vestiges, such as the pyramidal lobe and thyroglossal duct, are anatomical variations.
The clinical significance of these vestiges in various thyroid conditions requires further elucidation.

Purpose of the Study:

To evaluate the diagnostic utility of I-123 thyroid scintigraphy in identifying thyroid gland vestiges.
To correlate the presence of these vestiges with specific thyroid pathologies, including hyperthyroidism and euthyroidism.

Main Methods:

Retrospective analysis of I-123 thyroid scintigrams from 349 patients.
Focused evaluation for the presence of pyramidal lobe and thyroglossal duct.
Comparison of vestige detection rates across different thyroid functional states (hyperthyroidism, euthyroidism) and etiologies (Graves' disease, autonomously functioning nodules).

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Main Results:

Detection of thyroid vestiges in patients with hyperthyroidism suggests autoimmune etiology, particularly Graves' disease.
Graves' disease shows a significantly higher frequency of thyroglossal duct vestiges compared to autonomously functioning nodules.
In euthyroid patients, vestiges may indicate iodine deficiency or latent hypothyroidism.

Conclusions:

I-123 thyroid scintigraphy is effective in visualizing thyroid gland vestiges.
The presence of pyramidal lobe and thyroglossal duct on scintigraphy aids in differentiating causes of hyperthyroidism and suggests underlying iodine deficiency in euthyroid states.
I-123 offers superior visualization of these vestiges compared to Tc-99m sodium pertechnetate.