计算机断层扫描中的偶然甲状腺结节:系统性审查和元分析检查恶性病的流行率,随访和风险
Zhixing Song1, Christopher Wu1, Julia Kasmirski1
1Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Thyroid : official journal of the American Thyroid Association
|September 16, 2024
概括
计算机断层扫描 (CT) 扫描经常检测甲状腺附带瘤,通常是良性的. 建议放射科医生和甲状腺专家之间的协作方法来管理高风险的意外瘤,以确保最佳的患者护理.
科学领域:
- 辐射学和内分泌学.
- 诊断成像 诊断成像 诊断成像
- 在瘤学瘤学.
背景情况:
- 计算机断层扫描 (CT) 的使用量有所增加,导致甲状腺结节的偶然发现更频繁.
- 目前缺乏CT检测到的甲状腺附带瘤的管理指南.
- 这突显出需要了解它们的流行,随访和恶性瘤风险.
研究的目的:
- 为了确定CT检测到的甲状腺偶发瘤的患病率.
- 分析这些偶发性瘤的现有后续实践.
- 评估与CT上发现的甲状腺偶发瘤相关的恶性瘤 (ROM) 风险.
主要方法:
- 对2024年4月12日之前发表的研究进行了系统审查和元分析.
- 搜索的数据库包括PubMed,Embase和Cochrane. 这些数据库的搜索内容包括:
- 使用随机效应模型的聚合比例来分析流行率,随访率和ROM,并进行子组分析.
主要成果:
- 在CT上甲状腺附带瘤的总体患病率为8.3%,在部CT上患病率较高 (16.5%),而不是胸部CT (6.6%).
- 结节≥1厘米占发现的46.3%. 随访超声波,活检或手术分别发生在34.9%,28.4%和8.2%的病例中.
- 整体ROM为3.9%,随着结节大小显著增加 (例如,结节≥1厘米的11.7%).
结论:
- 大多数通过CT检测到的甲状腺附带瘤都是良性的.
- 很大一部分这些偶发性瘤大于1厘米,需要仔细考虑.
- 在放射科医生和甲状腺专家之间建立协作协议对于适当的管理和患者护理至关重要.
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