血清促甲状腺激素水平预测甲状腺摄取和扫描的效用。

IF 1.5 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Endocrine Research Pub Date : 2021-02-01 Epub Date: 2020-09-02 DOI:10.1080/07435800.2020.1810064
Lauren Buehler, Alireza Movahed, Keren Zhou, M Cecilia Lansang
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引用次数: 0

摘要

背景:甲状腺摄取与扫描(TUS)是鉴别甲状腺毒症病因的临床工具。虽然指南建议使用TUS来评估低TSH水平,但没有明确的数值。本研究旨在确定一个TSH临界值,在这个临界值下,TSH产生了更大的成功确定病因的可能性,以避免不必要的检测。方法:这是一项回顾性研究,由一位内分泌学家为评估低TSH而接受TUS的137例患者(结果:90%的TSH (n = 123)导致诊断,而10% (n = 14)不确定或正常。诊断包括Graves病(52%)、中毒性多结节性甲状腺肿(19%)、甲状腺炎(12%)和单发中毒性腺瘤(7%)。TSH中位值为0.008 μU/mL (IQR为0.005,0.011),游离T4中位值为1.7 μU/mL (IQR为1.3,2.8)。ROC分析的曲线下面积为0.86。预测诊断产率的最佳TSH临界值为0.02 μU/mL(灵敏度80%,特异性93%)。结论:本研究表明,TSH是一个有用的预测效用的TUS在产生甲状腺毒症的病因。我们的分析表明,当TSH≤0.02 μU/mL时,TUS有更大的可能性确定病因。当TUS不太可能帮助确定甲状腺毒症的病因时,这些信息可以帮助临床医生避免不必要的费用和患者时间负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum thyroid stimulating hormone level for predicting utility of thyroid uptake and scan.

Background: Thyroid uptake and scan (TUS) is a clinical tool used for differentiation of thyrotoxicosis etiologies. Although guidelines recommend ordering a TUS for evaluation of low TSH levels, no specific value is defined. This study aimed to determine a TSH cutoff at which TUSs yield a greater likelihood of successful determination of etiology to avoid unnecessary testing.

Methods: This was a retrospective study on 137 patients seen by an endocrinologist who underwent TUS for evaluation of low TSH (<0.4 μU/mL). A receiver operating curve analysis was performed to determine the TSH cutoff with maximal sensitivity and specificity for prediction of diagnostic utility.

Results: Ninety percent of TUSs (n = 123) led to a diagnosis, while 10% (n = 14) were inconclusive or normal. Diagnoses included Graves' diseases (52%), toxic multinodular goiter (19%), thyroiditis (12%), and solitary toxic adenoma (7%). The median TSH value was 0.008 μU/mL (IQR 0.005, 0.011), and the median free T4 value was 1.7 μU/mL (IQR 1.3, 2.8). The ROC analysis produced an area under the curve of 0.86. The optimal TSH cutoff value was 0.02 μU/mL (sensitivity 80%, specificity 93%) for prediction of diagnostic yield.

Conclusion: This study demonstrates that TSH is a useful predictor of the utility of TUS in yielding an etiology of thyrotoxicosis. Our analysis showed that TUS had a greater likelihood of determining an etiology when TSH was ≤0.02 μU/mL. This information can help clinicians avoid unnecessary cost and patient time burden when TUS is unlikely to aid in determining the etiology of thyrotoxicosis.

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来源期刊
Endocrine Research
Endocrine Research 医学-内分泌学与代谢
CiteScore
4.30
自引率
0.00%
发文量
10
审稿时长
>12 weeks
期刊介绍: This journal publishes original articles relating to endocrinology in the broadest context. Subjects of interest include: receptors and mechanism of action of hormones, methodological advances in the detection and measurement of hormones; structure and chemical properties of hormones. Invitations to submit Brief Reviews are issued to specific authors by the Editors.
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