Cooper J C, Nakielny R, Talbot C H
Department of Surgery, Royal Hallamshire Hospital, Sheffield.
Ann R Coll Surg Engl. 1991 Jan;73(1):32-5.
This study reports one unit's experience of the value of computed tomography (CT) in the evaluation of 24 patients with large cervical and retrosternal goitres. Of these patients, 17 were thought clinically to have symptoms of tracheal compression, but the CT demonstrated significant narrowing in only 12 cases. In the other five patients, surgery was deferred and other causes for their symptoms sought and treated. Seven patients were asymptomatic and CT failed to reveal any evidence of tracheal compression in six. In the remaining patient, however, CT revealed gross narrowing and urgent surgery was performed. When compared with CT, chest/thoracic inlet radiographs were misleading in 48% of patients, with tracheal narrowing being overestimated and underestimated. We conclude that CT gives useful information about tracheal compression in patients with large multinodular goitres, and is more accurate than chest/thoracic inlet radiographs.
本研究报告了一个医疗单位对24例巨大颈部和胸骨后甲状腺肿患者进行计算机断层扫描（CT）评估的经验。在这些患者中，17例临床诊断有气管受压症状，但CT仅显示12例有明显狭窄。另外5例患者推迟了手术，对其症状的其他病因进行了查找和治疗。7例患者无症状，CT显示其中6例无气管受压迹象。然而，在其余1例患者中，CT显示气管严重狭窄，遂进行了紧急手术。与CT相比，胸部/胸廓入口X线片在48%的患者中产生了误导，气管狭窄被高估或低估。我们得出结论，CT可为巨大多结节性甲状腺肿患者提供有关气管受压的有用信息，且比胸部/胸廓入口X线片更准确。
