甲状腺疾病讲解材料.pptVIP

Disorders of the Thyroid Gland;Overview of the Thyroid Gland;;Between the cricoid cartilage and the suprasternral notch 12-20g in size, highly vascular ,and soft in consistency Parathyroid gland are located to each pole of the thyroid Recurrent laryngeal nerves traverse the lateral borders;Hypothalamic-Pituitary-Thyroid Axis;   Graves disease;Pathogenesis ;Figure 7-15 Possible sequence and clinical outcome in AITD, indicating the interrelation of envirenmental and genetic factors, and dependence of the clinical picture on the type of immune response. ;1. Hot;;;Palpebral edema;Conjuntival injection and chemosis;Paralysis of upward Gaze on the right;Figure 12-3. End stage in severe involvement of extraocular muscles in ophthalmopathy;Assessment of severity;;胫前粘液性水肿;Figure 12-7. (a) Massive infiltrative , localized myxedema in a female patient with Graves disease and progressive exophthalmos. The lesions have become confluent over the lower extremities. (b) In the same patient, localized myxedema, involving the phalanges, is evident. ;;Laboratory Evaluation;Factors affecting TBG;Laboratory Evaluation;Image Evaluation;Figure 6-6. Thyroid Scans. Normal thyroid imaged with 123I. Cold nodule in the right lobe imaged by 99mTc. Elderly woman with obvious multinodular goiter and the corresponding radioiodide scan on the right. ;Figure 18-3. Scintiscans of thyroid. The scan on the left is normal.? A typical? scan of a cold thyroid nodule failing to accumulate iodide isotope is shown on the right.? Incidentally, a pyramidal lobe is also seen on this scan, which might suggest the presence of Hashimotos Thyroiditis. ;Figure 13-1. Hot nodule in right lobe of thyroid. Note that uptake of radioactivity in the contralateral lobe issuppressed. ;;(b) In this transverse view the enlarged muscles are seen (appearing dark against the light fat signal) and the exophthalmos is apparrent. ;;Differential Diagnosis;Hyperthyroidism with a high radioiodine uptake;Hyperthyroidism