rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2022-103-4-6-108-116rentrad-747Research ArticleОБЗОРЫREVIEWSСцинтиграфия при узловой патологии щитовидной железыScintigraphy in Thyroid Nodular Pathologyhttps://orcid.org/0000-0002-8373-0505МироновС. П.MironovS. P.

Миронов Сергей Петрович, д. м. н., профессор, врач-радиолог лаборатории радиоизотопной диагностики и терапии отдела радионуклидной диагностики и позитронно-эмиссионной томографии

ул. 3-я Черепковская, 15а, Москва, 121552

Sergey P. Mironov, Dr. Med. Sc., Professor, Radiologist, Laboratory of Radioisotope Diagnostics and Therapy, Department of Radionuclide Diagnostics and Positron Emission Tomography

ul. Tretya Cherepkovskaya, 15а, Moscow, 121552

msp1942@yandex.ruhttps://orcid.org/0000-0002-0487-6902СергиенкоВ. Б.SergienkoV. B.

Сергиенко Владимир Борисович, д. м. н., профессор, руководитель отдела радионуклидной диагностики и позитронно-эмиссионной томографии

ул. 3-я Черепковская, 15а, Москва, 121552

Vladimir B. Sergienko, Dr. Med. Sc., Professor, Head of Department of Radionuclide Diagnostics and Positron Emission Tomography

ul. Tretya Cherepkovskaya, 15а, Moscow, 121552

Научно-исследовательский институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии им. академика Е.И. Чазова» Минздрава РоссииРоссияMyasnikov Research Institute of Clinical Cardiology, Chyazov National Medical Research Center for CardiologyRussian Federation2022271020221034-6108116Copyright © Миронов С.П., Сергиенко В.Б., 20222022Миронов С.П., Сергиенко В.Б.Mironov S.P., Sergienko V.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/747

Сцинтиграфия щитовидной железы (ЩЖ) – метод, сформировавшийся более 60 лет назад и сохраняющий свое значение для диагностики и оценки риска злокачественности узловой патологии. В обзоре рассматривается использование сцинтиграфического метода при функциональной и метаболической оценке узлового зоба. Изложены предпосылки для функционального скрининга узлов ЩЖ с короткоживущим 99mТс-пертехнетатом. Приведены сведения о принципах его получения и фармакокинетике, а также о вариантах функциональной активности узлов ЩЖ, их возможном злокачественном потенциале и показаниях к метаболическому скринингу. Характеристика метаболической активности позволяет оценить риск малигнизации функционально «холодных» узлов ЩЖ. Представлены основные этапы использования неспецифических туморотропных радиофармпрепаратов, механизм их накопления и метаболизма в опухолях ЩЖ, возможности дифференциальной диагностики различных типов узловых образований. Современные взгляды на диагностические возможности двухфазной сцинтиграфии с 99mТс-метилизобутил изонитрилом отражены с учетом взаимосвязи поглощения радиофармпрепаратов с факторами пролиферативной активности и ультраструктурными типами клеток, вариантом онкоцитарной патологии и экспрессией белка множественной лекарственной устойчивости.

Thyroid scintigraphy is a method that formed more than 60 years ago and retains its importance for the diagnosis and assessment of the risk of nodular malignancy. The review examines the use of the scintigraphic method in functional and metabolic assessment of nodular goiter. Prerequisites for functional thyroid nodes screening with short-lived 99mTc-pertechnetate are outlined. Information is provided on the principles of its preparation and pharmacokinetics, as well as variants of the thyroid nodes functional activity, their possible malignant potential and indications for metabolic screening. The characteristic of metabolic activity allows to assess the risk of functionally “cold” thyroid nodes malignancy. The main stages of the use of nonspecific tumorotropic radiopharmaceuticals, the mechanism of their accumulation and metabolism in the thyroid tumors, the possibilities of the differential diagnosis of various types of nodular formations are presented. Modern views on the diagnostic capabilities of two-phase scintigraphy with 99mTс-methylisobutylisonitrile are reflected taking into account the relationship of radiopharmaceuticals accumulation with factors of proliferative activity and ultrastructural cell types, a variant of oncocytic pathology and multidrug-resistant protein expression.

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The authors declare that there are no conflicts of interest present.