甲状腺功能亢进症合并胸腺增生CT观察  

CT Diagnosis of Thymic Hyperplasia in Patients with Hyperthyroidism

作　　者：周全[1] 李洁[1] 陈金城[1] 杨侃荣[1] 康举龄[2] 

机构地区：[1]暨南大学第一附属医院医学影像中心,广州510630 [2]暨南大学第一附属医院病理科,广州510630

出　　处：《临床放射学杂志》2011年第4期485-488,共4页Journal of Clinical Radiology

摘　　要：目的通过CT追踪观察甲状腺功能亢进症合并胸腺增大患者诊治过程中胸腺的改变,提高对该病的诊断及鉴别诊断水平,以避免不必要的创伤性活组织检查及外科手术。资料与方法对7例甲状腺功能亢进患者并发胸腺增生的临床表现、诊疗过程及CT追踪观察胸腺病变的变化进行回顾性分析。结果 7例中,2例行胸腺手术治疗(1例因误诊胸腺瘤行胸腺手术,术后症状未改善,短期内复查见胸腺增生)。7例行抗甲状腺药物治疗后临床症状好转,复查CT显示6例胸腺较前减小[体积平均减小(9.32±1.60)cm3],CT值密度降低[平均降低(53±11)HU],1例术后未见胸腺增生。结论部分患者的胸腺增大可能与甲状腺功能亢进相关,通过抗甲状腺药物治疗后,胸部CT可以显示增生胸腺变小及密度减低。甲状腺功能亢进症合并前纵隔的肿块没有必要立即进行穿刺活检及手术切除。通过观察临床表现,完善相关的实验室检查及追踪病变的CT变化可以对甲状腺功能亢进合并胸腺增生进行定性诊断,从而避免创伤性的活组织检查及开胸手术。Objective To investigate the dynamic changes of CT manifestations of thymic hyperplasia in patients with hyperthyroidism before and after antithyroid therapy in order to guide clinical diagnosis,therapy and follow-up.Materials and Methods Clinical manifestations,treatment and CT followed for changes in the seven cases of hyperthyroidism with thymic hyperplasia were retrospectively analyzed.Results Seven cases of hyperthyroidism with thymic hyperplasia,two cases was treated by surgical excision（including one patient misdiagnosed as thymoma,symptoms and thymus hyperplasia did not improved after surgical treatment,but thymic hyperplasia appeared again shortly） After giving antithyroid drug therapy,the clinical symptoms of all cases were improved,CT showed the size of thymus was decreased [the average volume decreased（9.32±1.60） cm3],CT values of the density decreased [average decrease（53±11） HU].Conclusion The enlargement of thymus in patients with hyperthyroidism may be related to thyroid hyperfunction.After antithyroid drug therapy,chest CT show the regression of thymic mass and the decrease of soft tissue attenuation in hyperplastic thymic tissue.An anterior mediastinal mass associated with hyperthyroidism may not require resection or immediate biopsy.By observing the clinical manifestations,consummating laboratory examination and follow-up CT changes in thymic tissue are helpful to diagnosis of thymus hyperplasia with hyperthyroidism,meanwhile,it can avoid invasive biopsy and thoracotomy.

关 键 词：胸腺增生 甲状腺功能亢进症 体层摄影术 X线计算机 

分 类 号：R581.1[医药卫生—内分泌]