Oatridge Angela, Barnard Maria L, Puri Basant K, Taylor-Robinson Simon D, Hajnal Joseph V, Saeed Nadeem, Bydder Graeme M
Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, Faculty of Medicine, Imperial College, Hammersmith Hospital Campus, London W12 0HS, England, UK.
AJNR Am J Neuroradiol. 2002 Oct;23(9):1539-44.
Although neuropsychological symptoms and signs are common in thyroid disease, their organic substrate is unknown. We performed brain MR imaging in patients with hyperthyroidism or hypothyroidism before and after treatment and correlated the results with hormonal markers.
Eight patients with hyperthyroid disease and three with hypothyroid disease underwent imaging within 1-2 days of a thyroid hormone testing. Images were registered, and brain and ventricular sizes were measured by using a semiautomated contour and thresholding technique. Changes in brain and ventricular volume were correlated with serum levels of total thyroxine (T(4)), unbound triiodothyronine (free T(3)), and thyroid-stimulating hormone (TSH) before and after treatment.
With treatment, brain size decreased by 6,329-31,183 mm(3) in the hyperthyroid group and increased by 2,599-48,825 mm(3) in the hypothyroid group. Conversely, with treatment, ventricular size increased by 325-6,279 mm(3) in the hyperthyroid group and decreased by 760-2,376 mm(3) in the hypothyroid group. There was a highly significant correlation between reduction in brain size and reduction in T(4), as well as between the increase in ventricular size and reduction in T(4). There was a significant correlation between reduction in ventricular size and reduction in free T(3). There were highly significant correlations between reduced levels of TSH and increase in brain size, as well as between increased levels of TSH and increase in ventricular size.
In thyroid disease, the size of the brain and ventricles significantly change after treatment, and these changes are correlated with T(4), free T(3), and TSH levels. The mechanism of these changes is uncertain, but it may involve osmolyte regulation, the sodium and water balance, and alterations in cerebral hemodynamics.
尽管神经心理学症状和体征在甲状腺疾病中很常见，但其器质性基础尚不清楚。我们对甲状腺功能亢进或减退患者治疗前后进行了脑部磁共振成像，并将结果与激素指标相关联。
8例甲状腺功能亢进患者和3例甲状腺功能减退患者在甲状腺激素检测的1 - 2天内接受成像。对图像进行配准，并使用半自动轮廓和阈值技术测量脑和脑室大小。治疗前后脑和脑室体积的变化与血清总甲状腺素（T(4)）、游离三碘甲状腺原氨酸（游离T(3)）和促甲状腺激素（TSH）水平相关。
治疗后，甲状腺功能亢进组脑体积减少6329 - 31183立方毫米，甲状腺功能减退组脑体积增加2599 - 48825立方毫米。相反，治疗后，甲状腺功能亢进组脑室体积增加325 - 6279立方毫米，甲状腺功能减退组脑室体积减少760 - 2376立方毫米。脑体积减小与T(4)降低之间以及脑室体积增加与T(4)降低之间存在高度显著相关性。脑室体积减小与游离T(3)降低之间存在显著相关性。TSH水平降低与脑体积增加之间以及TSH水平升高与脑室体积增加之间存在高度显著相关性。
在甲状腺疾病中，治疗后脑和脑室大小会发生显著变化，且这些变化与T(4)、游离T(3)和TSH水平相关。这些变化的机制尚不确定，但可能涉及渗透溶质调节、钠和水平衡以及脑血流动力学改变。
