Section of Radiology, Department of Internal Medicine and Public Medicine, University of Bari Medical School, Bari, Italy.
Thyroid. 2010 Feb;20(2):181-7. doi: 10.1089/thy.2009.0107.
Diagnostic imaging provides useful anatomical and morphological information of cervico-mediastinal goiters. The aim of this study was to assess the usefulness of multidetector computed tomography (MDCT) with multiplanar reformatting and volume rendering reconstructions for the preoperative evaluation of retrosternal goiters in patients for whom magnetic resonance imaging is contraindicated.
From March 2006 to January 2009, 34 patients (20 women and 14 men; mean age, 48 years; range, 42-74 years) with suspected cervico-mediastinal goiter were assessed by MDCT after intravenous injection of contrast material. The following parameters were evaluated: morphology, size, and enhancement of thyroid lobes; presence, location, and mediastinal extension of thyroid tissue; and relations with mediastinal vessels and organs. All patients underwent thyroidectomy. A reference group of 34 patients evaluated by single-detector computed tomography was created. The two groups of patients were compared searching for operative time (OT, in hours), hospital stay (HS, in days), and morbidity rate observed after thyroid surgery in all cases.
In 29/34 patients, thyroid was enlarged with left mediastinal extension in 12 cases, right extension in 10 cases, and posterior extension in 7 cases. In 3/34 patients, a normal cervical thyroid connected to the mediastinal goiter through a thin parenchymal stripe was observed. In 2/34 patients, thyroid lobes were enlarged, without mediastinal extension. By comparing the two groups of patients for OT and HS values, a significant reduction to 3.7 +/- 0.1 hours and 4.3 +/- 0.1 days, respectively, was found in the group of MDCT patients, and also a trend to the reduction for morbidity rate (21%) could be recognized.
MDCT represents a noninvasive tool in the evaluation of retrosternal goiters. High-quality multiplanar reformatting and volume rendering reconstructions allow an optimal analysis of the plunged gland and could reduce OT, HS, and probably the morbidity rate.
诊断成像提供了有用的颈纵隔甲状腺肿的解剖和形态学信息。本研究的目的是评估多排螺旋 CT（MDCT）多平面重建和容积再现重建在因磁共振成像禁忌而对胸骨后甲状腺肿患者进行术前评估的有用性。
从 2006 年 3 月至 2009 年 1 月，对 34 例（20 名女性和 14 名男性；平均年龄 48 岁；范围 42-74 岁）疑似颈纵隔甲状腺肿的患者进行 MDCT 检查，静脉注射造影剂。评估了以下参数：甲状腺叶的形态、大小和增强；甲状腺组织的存在、位置和纵隔延伸；以及与纵隔血管和器官的关系。所有患者均行甲状腺切除术。创建了一个由 34 例患者组成的单探测器 CT 评估参考组。比较两组患者，寻找手术时间（OT，小时）、住院时间（HS，天）和所有甲状腺手术后的发病率。
在 34 例患者中，29 例甲状腺肿大，12 例左侧纵隔延伸，10 例右侧延伸，7 例后侧延伸。在 34 例患者中，观察到正常的颈甲状腺通过薄实质带与纵隔甲状腺相连。在 34 例患者中，2 例甲状腺叶肿大，无纵隔延伸。比较两组患者的 OT 和 HS 值，MDCT 组的 OT 和 HS 值分别显著减少到 3.7 +/- 0.1 小时和 4.3 +/- 0.1 天，发病率也呈下降趋势（21%）。
MDCT 是评估胸骨后甲状腺肿的一种非侵入性工具。高质量的多平面重建和容积再现重建允许对陷入的腺体进行最佳分析，并可能减少 OT、HS，可能还会降低发病率。
