Taeymans Olivier, Penninck Dominique G, Peters Rachel M
Department of Clinical Sciences, Tufts University, North Grafton, MA, USA.
Vet Radiol Ultrasound. 2013 Jan-Feb;54(1):61-70. doi: 10.1111/j.1740-8261.2012.01966.x. Epub 2012 Sep 18.
This study compares clinical, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings in 16 prospectively, and seven retrospectively recruited dogs presented for suspected thyroid carcinoma. Of these, 17 were confirmed thyroid carcinoma, while six were initially misdiagnosed. These included four carotid body tumors, one para-esophageal abscess, and one undifferentiated squamous cell carcinoma. Thyroid carcinomas occurred in older dogs without evidence of sex predilection, and were more often unilateral. All were large, heterogeneous, moderately to strongly vascularized, and most commonly contained areas of dystrophic mineralization and/or fluid accumulations. On MRI, thyroid carcinomas appeared hyperintense compared to surrounding musculature in all imaging sequences used, while on CT they had a lower attenuation value than normal thyroid gland tissue. Histologically confirmed tumor capsule disruption with invasion of the surrounding structures was most commonly detected with MRI. Palpation was not an accurate predictor of locally invasive vs. well-encapsulated masses. Computed tomography had the highest specificity (100%) and MRI had the highest sensitivity (93%) in diagnosing thyroid carcinoma, while ultrasound had considerably lower results. We conclude that ultrasound is adequate for use as a screening tool for dogs with suspected thyroid carcinoma, but recommend either CT or MRI for preoperative diagnosis and staging.
本研究比较了16只前瞻性和7只回顾性招募的疑似甲状腺癌犬的临床、超声、计算机断层扫描(CT)、磁共振成像(MRI)及病理检查结果。其中,17只确诊为甲状腺癌,6只最初被误诊。误诊病例包括4例颈动脉体瘤、1例食管旁脓肿和1例未分化鳞状细胞癌。甲状腺癌发生于年龄较大的犬,无性别倾向,且多为单侧性。所有肿瘤均较大,形态不均一,血供中等至丰富,最常见的是含有营养不良性矿化和/或积液区域。在MRI上,在所使用的所有成像序列中,甲状腺癌相对于周围肌肉组织呈高信号,而在CT上其衰减值低于正常甲状腺组织。组织学证实的肿瘤包膜破裂伴周围结构侵犯最常通过MRI检测到。触诊对于判断肿块是局部浸润性还是包膜完整并不准确。CT在诊断甲状腺癌方面特异性最高(100%),MRI敏感性最高(93%),而超声的诊断结果则低得多。我们得出结论,超声足以作为疑似甲状腺癌犬的筛查工具,但建议术前诊断和分期采用CT或MRI。