自然史和长期随访CT成像中的偶然甲状腺结节
1School of Medicine, University of Glasgow, Glasgow, G12 8QQ, United Kingdom.
The British journal of radiology
|January 21, 2025
概括
在CT扫描中检测到的偶然的甲状腺结节 (ITN) 很少导致临床上明显的甲状腺癌. 大多数ITN患者死于其他原因,这表明可能不需要进行例行调查.
科学领域:
- 放射学 放射学是一门学科.
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 偶然的甲状腺结节 (ITN) 经常在CT扫描中被发现.
- 越来越多地使用横截面成像与全球甲状腺癌发病率的上升有关.
- 由于恶性瘤的发病率为5%-15%,因此ITNs存在管理挑战,尽管差异化甲状腺癌的预后通常很好.
研究的目的:
- 在CT扫描上确定ITNs≥1cm的流行率.
- 评估ITN的报告实践.
- 评估13年随访期间临床明显的甲状腺癌的发展,结节生长和临床结果.
主要方法:
- 2009年1月对包括甲状腺在内的1499次连续CT扫描进行了回顾性审查.
- 分析到2022年1月为止的临床数据,对150名至少有一个ITN≥1厘米的患者进行分析.
主要成果:
- ITNs的患病率为11%,患者平均年龄为70岁,平均结节直径为17.5毫米.
- 只有30%的ITN在CT报告中被提及.
- 在随访期间,11%的患者接受了超声波,5%的患者接受了细针吸收,2%的患者接受了诊断性甲状腺切除术,但没有发现甲状腺恶性瘤. 80%的患者在研究终点时死于非甲状腺原因.
结论:
- 在13年内150例ITN病例中没有出现临床明显的甲状腺恶性瘤.
- 由于非甲状腺原因的高死亡率表明ITNs的预后有利.
- 在CT上检测到的ITN的进一步检查可能不需要例行检查,除非怀疑恶性瘤或临床指示.
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