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European Journal of Nuclear Medicine and Molecular Imaging

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01.12.2004 | Original Article

Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis

verfasst von: M. Piga, A. Serra, L. Deiana, G. L. Loi, L. Satta, M. Di Liberto, S. Mariotti

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2004

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Abstract

Purpose

Brain perfusion abnormalities have recently been demonstrated by single-photon emission computed tomography (SPECT) in rare cases of severe Hashimoto’s thyroiditis (HT) encephalopathy; moreover, some degree of subtle central nervous system (CNS) involvement has been hypothesised in HT, but no direct evidence has been provided so far. The aim of this study was to assess cortical brain perfusion in patients with euthyroid HT without any clinical evidence of CNS involvement by means of^99mTc-ECD brain SPECT. Sixteen adult patients with HT entered this study following informed consent.

Methods

The diagnosis was based on the coexistence of high titres of anti-thyroid auto-antibodies and diffuse hypoechogenicity of the thyroid on ultrasound in association with normal circulating thyroid hormone and TSH concentrations. Nine consecutive adult patients with non-toxic nodular goitre (NTNG) and ten healthy subjects matched for age and sex were included as control groups. All patients underwent ^99mTc-ECD brain SPECT. Image assessment was both qualitative and semiquantitative. Semiquantitative analysis was performed by generation of four regions of interest (ROI) for each cerebral hemisphere—frontal, temporal, parietal and occipital—and one for each cerebellar hemisphere in order to evaluate cortical perfusion asymmetry. The Asymmetry Index (AI) was calculated to provide a measurement of both magnitude and direction of perfusion asymmetry.

Results

As assessed by visual examination, ^99mTc-ECD cerebral distribution was irregular and patchy in HT patients, hypoperfusion being more frequently found in frontal lobes. AI revealed abnormalities in 12/16 HT patients, in three of the nine NTNG patients and in none of the normal controls. A significant difference in the mean AI was found between patients with HT and both patients with NTNG (p<0.003) and normal controls (p<0.001), when only frontal lobes were considered.

Conclusion

These results show the high prevalence of brain perfusion abnormalities in euthyroid HT. These abnormalities are similar to those observed in cases of severe Hashimoto’s encephalopathy and may suggest a higher than expected involvement of CNS in thyroid autoimmune disease.

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Titel: Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis
verfasst von: M. Piga
A. Serra
L. Deiana
G. L. Loi
L. Satta
M. Di Liberto
S. Mariotti
Publikationsdatum: 01.12.2004
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 12/2004
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1625-7

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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