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多层螺旋计算机断层扫描评估犬类偶然和非偶然甲状腺肿瘤:一项对4520只犬的单中心横断面研究

INCIDENTAL AND NONINCIDENTAL CANINE THYROID TUMORS ASSESSED BY MULTIDETECTOR ROW COMPUTED TOMOGRAPHY: A SINGLE-CENTRE CROSS SECTIONAL STUDY IN 4520 DOGS.

作者信息

Bertolini Giovanna, Drigo Michele, Angeloni Luca, Caldin Marco

机构信息

Diagnostic and Interventional Radiology, San Marco Veterinary Clinic, via Sorio 114/c, 35141 Padova, Italy.

Dipartimento di Medicina Animale, Produzioni e Salute, Università degli Studi di Padova Scuola di Agraria e Medicina Veterinaria, Italy.

出版信息

Vet Radiol Ultrasound. 2017 May;58(3):304-314. doi: 10.1111/vru.12477. Epub 2017 Feb 9.

DOI:10.1111/vru.12477
PMID:28185344
Abstract

Thyroid nodules are common in dogs and are increasingly likely to be detected with the increased use of advanced imaging modalities. An unsuspected, nonpalpable, asymptomatic lesion, defined as a thyroid incidentaloma, may be discovered on an imaging study unrelated to the thyroid gland. The objective of this single-center cross-sectional study was to assess the prevalence and computed tomography (CT) characteristics of incidental and nonincidental thyroid tumors in a large population of dogs, using prospective recruitment of patients undergoing CT examination for various reasons during the period of 2005-2015. Unilateral or bilateral thyroid masses were detected in 96/4520 dogs (prevalence, 2.12%; 95% confidence interval [CI], 1.70-2.54%). Seventy-nine (82.3%) lesions were malignant and 17 (17.7%) were benign. Masses were discovered incidentally in 34/96 dogs (overall prevalence of incidentaloma, 0.76%; 95% CI, 0.51-1.02), and 24 (70.6%) of these 34 masses were thyroid carcinomas. Among the CT variables assessed, mineralization, vascular invasion, and tissue invasion were detected only in malignant tumors. Intratumoral vascularization was significantly associated with the presence of thyroid malignancy (P < 0.001). Although incidental thyroid nodules in dogs are relatively rare, they are often malignant. Findings indicated that the neck should be thoroughly assessed in middle-aged and old patients undergoing body CT for various reasons. Thyroid nodules detected incidentally on CT should be sampled to avoid missing thyroid cancer.

摘要

甲状腺结节在犬类中很常见,并且随着先进成像技术使用的增加,其被检测到的可能性也越来越大。在一项与甲状腺无关的成像研究中,可能会发现一个未被怀疑、触诊不到且无症状的病变,即甲状腺偶发瘤。这项单中心横断面研究的目的是,通过前瞻性招募在2005年至2015年期间因各种原因接受CT检查的患者,评估一大群犬类中偶发性和非偶发性甲状腺肿瘤的患病率及计算机断层扫描(CT)特征。在4520只犬中检测到单侧或双侧甲状腺肿块的有96只(患病率为2.12%;95%置信区间[CI],1.70 - 2.54%)。其中79个(82.3%)病变为恶性,17个(17.7%)为良性。在96只犬中有34只(偶发瘤的总体患病率为0.76%;95% CI,0.51 - 1.02)偶然发现了肿块,这34个肿块中有24个(70.6%)是甲状腺癌。在所评估的CT变量中,仅在恶性肿瘤中检测到矿化、血管侵犯和组织侵犯。瘤内血管形成与甲状腺恶性肿瘤的存在显著相关(P < 0.001)。尽管犬类中的偶发性甲状腺结节相对少见,但它们通常是恶性的。研究结果表明,对于因各种原因接受身体CT检查的中老年患者,应全面评估其颈部。CT检查时偶然发现的甲状腺结节应进行采样,以避免漏诊甲状腺癌。

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