title: Neonatal hypothyroid disease: absent salivary gland evident on technetium-99m pertechnetate scan.
abstract: OBJECTIVE
  Technetium-99m pertechnetate scintigraphy is a well-established technique for diagnosing congenital hypothyroid disease. However, the biodistribution of pertechnetate (TcO4-) in neonates and young infants is not well documented. The purpose of this study was to analyze and document the biodistribution of TcO4- in young infants.
  
  
  METHODS
  Scintigraphic studies of 31 patients being examined for hypothyroid disease were analyzed. All patients had elevated levels of thyroid-stimulating hormone. Dyshormonogenesis was diagnosed in 7 patients, ectopic thyroid glands in 19, and agenesis in 5.
  
  
  RESULTS
  Images of the neck, chest, and abdomen taken in the anterior and left lateral positions using a low-energy, all-purpose collimator were reviewed. Twenty-six of the patients had no accumulation of the isotope in the salivary glands and 11 had no gastric uptake on either view.
  
  
  CONCLUSIONS
  Based on the absence of salivary gland activity in the patients examined, this study suggests that this is a normal finding in infants younger than 3 months. A lateral view of the neck with markers is sufficient to localize the thyroid gland, because any activity in the neck region would belong to the thyroid. Furthermore, poor and variable uptake of the isotope in the stomach may lead to false-negative results, so caution is urged in the use of this tracer in Meckel's scintigraphy in young infants, particularly if the study findings are within normal limits.
authors: Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom. pinar_kiratli@hotmail.com
authors: P O
authors: PO
authors: Kiratli
authors: I
authors: I
authors: Gordon
authors: N
authors: N
authors: Nagaraj
mesh_terms: D003409:Congenital Hypothyroidism; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000000981:diagnostic imaging*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012469:Salivary Glands / Q000000981:diagnostic imaging*; D013670:Sodium Pertechnetate Tc 99m
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m