Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Afr Health Sci. 2023 Dec;23(4):356-361. doi: 10.4314/ahs.v23i4.38.
Thoracic inlet view radiograph is an investigation for assessing patients with goitre in many centres in the sub-Saharan-region. However, there is paucity of information on its usefulness in the diagnosis of retrosternal goitre (RSG) and in planning for thyroidectomy.
A review of patients with goitre managed in the Division of Endocrine Surgery, University College Hospital, Ibadan, Nigeria, between 2002 and 2014 was done. Data were obtained from Operating Theatre Log and electronic data archive of the Division. Clinical RSG (CRSG) was taken as a gland that the examining fingers could not get below its lower margin and Radiological RSG (RRSG) on thoracic inlet view was any extension of the thyroid gland beyond the thoracic inlet. Intra-operatively, if any part of the gland extends beyond the thoracic inlet it was considered as an RSG.
221 (96.5%) of the 229 patients who had thoracic inlet plain radiograph were included in this study. The Male to Female ratio was 1:5.5. WHO grade III goitre was seen in 56.1% of the patients and 43.9% had grade II goitre. The CRSG, RRSG and Intra-operative RSG were seen in 7.7%, 16.7% and 17.6% respectively. The specificity and sensitivity of clinical examination in determining RSG was 88.7% and 94.1% and that of Thoracic inlet radiograph was 97.8% and 94.6% respectively.
It is a useful study for screening patients with goitre for retrosternal extension, however it could not be used to determine the need for extra-cervical surgical access during thyroidectomy.
在撒哈拉以南地区的许多中心，胸锁乳突肌入口视图射线照相是评估甲状腺肿患者的一种检查方法。然而，关于其在胸骨后甲状腺肿（RSG）诊断和甲状腺切除术计划中的有用性的信息很少。
对 2002 年至 2014 年在尼日利亚伊巴丹大学教学医院内分泌外科治疗的甲状腺肿患者进行了回顾性研究。数据来自手术室日志和该部门的电子数据档案。临床胸骨后甲状腺肿（CRSG）被定义为检查手指无法触及其下边缘的腺体，而胸锁乳突肌入口视图上的放射学胸骨后甲状腺肿（RRSG）是指甲状腺腺体超出胸锁乳突肌入口的任何延伸。术中，如果腺体的任何部分超出胸锁乳突肌入口，则被认为是胸骨后甲状腺肿。
在 229 名接受胸锁乳突肌入口平片的患者中，有 221 名（96.5%）患者被纳入本研究。男女比例为 1:5.5。WHO 分级 III 甲状腺肿见于 56.1%的患者，43.9%的患者有 II 级甲状腺肿。CRSG、RRSG 和术中 RSG 分别为 7.7%、16.7%和 17.6%。临床检查确定胸骨后甲状腺肿的特异性和敏感性分别为 88.7%和 94.1%，而胸锁乳突肌入口射线照相的特异性和敏感性分别为 97.8%和 94.6%。
对于筛查胸骨后甲状腺肿的患者，该研究是一种有用的研究方法，但不能用于确定甲状腺切除术时是否需要颈外手术入路。
