CT测量在评价甲状腺残留量及残留率中的应用研究  

Estimation of the remnant size and ratio of the thyroid gland by CT in subtotal thyroidectomy for Graves’disease.

作　　者：刘彤[1] 李志霞[1] 陈志雨[1] 王建国[1] 齐立行[2] 崔志刚[1] 许怀瑾[1] 

机构地区：[1]首都医科大学附属北京同仁医院,100730 [2]首都医科大学北京宣武医院血管外科,100053

出　　处：《中国实用外科杂志》2004年第11期672-674,共3页Chinese Journal of Practical Surgery

摘　　要：目的　探讨一种更精确而行之有效的测量甲状腺残留量的方法。方法　自 1996～ 2 0 0 1年对 15例原发性甲状腺功能亢进症病人于术前经CT对甲状腺进行体积测量 ,于双侧甲状腺次全切除术后 ,再用增强CT对上述病人残留甲状腺进行体积测量 ,并与术中测得残留量比较。结果　术中测得残留量 2 8～ 13 0 g ,术后CT测量为 3 4～ 16 6g ,二者之间有一定误差 (P =0 0 6 7) ,产生原因主要为术者对残留甲状腺背面气管旁沟处的不规则腺体测量不准确。体积切除率 83 1%～ 97 9% ,体积残留率 2 1%～ 17 9% ,活体组织相对体积质量 (1 0 5 4 8± 0 0 2 0 5 ) g/cm3 ,离体组织相对体积质量 (1 0 6 4 8± 0 0 188) g/cm3 。结论　CT测量更接近实际残留量 ,可重复性强 ,可比性强。体积残留率比腺体残留重量、手术切除率更具有个性化参考意义。Objective To explore a more efficient and accurate method to determine the remnant size and ratio of the thyroid gland in subtotal thyroidectomy for Graves disease. Methods From 1996 to 2001,thyroid glands of 15 patients with Graves' disease were scanned by CT before operation to calculate the volume of thyroid. Then subtotal thyroidectomy was performed on each patient. After operation, the volume of remnant thyroid,which was estimated by enhanced CT in all the patients, was compared with the size (and weight) determined by the surgeon during the operation. Results The weight of remnant thyroid determined by the surgeon during operation was 2.8～13.0g. Meanwhile the weight determined by CT was 3.4～16.6g. There was little difference between the weight of remnant thyroid measured during operation and that measured by CT (P=0.067). Main possible reason was the inaccuracy of surgeon's estimation of the irregular portion of the remnant thyroid in the paratracheal ditch of thyroid's back. Cut-off ratio of thyroid volume was 83.1%～97.9%. Remnant ratio of thyroid volume was 2.1%～17.2%. The specific gravity of living thyroid tissue was (1.0548±0.0205)g/cm3,and the specific gravity of left-off tissue was (1.0648±0.0188)g/cm3.Conclusion The proposed CT determination approach to determine remnant thyroid weight and size has the advantages of more accurate, repeatable and strongly comparable. In addition, the remnant ratio of volume as a metric has more value than ordinary remnant weight or operation cut-off ratio.

关 键 词：CT测量 甲状腺残留量 甲状腺残留率 原发性甲状腺功能亢进症 手术治疗 

分 类 号：R653[医药卫生—外科学]