甲状腺结节钙化与甲状腺癌的关系

 目的 探讨术前超声发现甲状腺结节钙化与甲状腺癌的关系。方法 回顾性分析武警总医院 2012 -06 至 2012 -08 行甲状腺结节手术的患者,术前超声检查的甲状腺结节钙化类型,以及和术中、术后病理结果之间关系。结果 58例中,良性病变31例,甲状腺乳头状癌27例。术前超声甲状腺结节钙化检出率39.7%,术后病理的钙化检出率为38%,术中冷冻的钙化检出率为17.2%。良性病变钙化检出率为16.1%,良性病变微钙化检出率6.4%;甲状腺乳头状癌钙化发生率66.7%,其中微钙化发生率为51.9%。良性病变与恶性病变之间的钙化发生率、微钙化发生率比较,差异均有统计学意义(P<0.01)。良性病变的单个结节钙化发生率为20%,恶性病变的单个结节钙化发生率为61.1%,两者比较差异有统计学意义(P<0.01)。结论 术前超声发现的甲状腺结节的微钙化与甲状腺癌的关系密切。     

Black thyroid

A distinctive but very rare side effect of exposure to minocycline is black pigmentation of the thyroid gland. Until 2002, not more than 30 cases of black thyroid had been reported in the English literature. We report on a 24-year-old woman with known antemortem ingestion of minocycline. The woman suffered from a depressive disorder with repeated suicide attempts and committed suicide by a gunshot to the head. At autopsy, the thyroid gland showed coal-black coloration. Upon histology, clumps of black-brown pigment were seen in the colloid, and a granular precipitate of this pigment was noted in the apical portions of the follicular epithelial cells. The diagnosis of minocycline-associated black thyroid was established. Forensic pathological significance of black thyroid may arise from the fact that hypothyroidism has been occasionally associated with minocycline-related black thyroid and that hypothyroidism may contribute to the development of depressive disorders (and thus, in given cases, may be responsible for suicide attempts). Under this assumption, the presence of black thyroid would represent more than just a morphological curiosity in specific cases.     

Simple thyroid cyst

Simple or true thyroid cysts are very rare. We only have found one case in which colorless and acellular transparent fluid has been found by means of the fine needle aspiration puncture (FNAP). We report the case of a 33 year old female who first presented with a rapidly growing thyroid nodule. The thyroid scintigraphy revealed the existence of a cold nodule and the ultrasonography showed a lesion having a cystic appearance. The FNAP was performed and was both diagnostic and therapeutic in this case.     

99Tcm-MIBI甲状腺显像鉴别甲状腺结节良恶性再认识

目的评价^99Tc^m-甲氧基异丁基异腈（MIBI）甲状腺亲肿瘤显像鉴别甲状腺结节良恶性的临床价值。方法106例甲状腺结节手术患者中101例先进行了甲状腺结节常^99Tc^mO4^-显像；106例患者均静脉注射^99Tc^m-MIBI 370 MBq后进行15min早期和2h延迟显像，结果与病理检查结果对比。结果13例甲状腺恶性肿瘤中的5例、93例良性结节中的23例^99Tc^m-MIBI显像阳性。^99Tc^m-MIBI显像诊断甲状腺恶性肿瘤的灵敏度为38．5％，特异性为75．3％，准确性为70．8％。甲状腺良恶性肿瘤显像的阳性率差异无显著性（x^2=0．49，P〉0．05）。结论^99Tc^m-MIBI显像不能鉴别甲状腺结节的良恶性，其临床意义有限。     

Gender differences in estimating I-131 thyroid uptake from Tc-99m thyroid uptake for benign thyroid disease

Objective:For radioactive Iodine-131 (¹³¹I) treatments of thyroid diseases, increased efficacy has been reported for personalized dosimetry treatments. The measurement of Iodine-131 thyroid uptake (¹³¹IU) is required in these cases. This study aims to investigate whether ^99mTc thyroid uptake (^99mTcU) may be used in place of ¹³¹IU for implementing personalised treatments.Methods:A retrospective study of 152 benign thyroid disease ¹³¹I treatments was carried out during 2012–2020; 117 treatments were for female patients while 35 were for male patients diagnosed with either Graves’ disease, multinodular goitre or toxic nodules.Results:A statistically significant correlation was found between ¹³¹IU and ^99mTcU data, with the data more correlated for male than female patients (r = 0.71 vs 0.38, p-value < 0.001). Patient age and time difference between the two respective uptake measurements significantly influenced the uptake correlation in females but not for the male cohort, although there was no significant difference between the parameters across gender. Thyroid diagnosis and hormone levels showed a significant correlation with uptakes in both genders. Estimating ¹³¹IU based on ^99mTcU was shown to be predictive for male but not in female patients (R² = 91% vs 16%).Conclusion:Estimating ¹³¹IU based on ^99mTcU is not recommended for females at our centre. Males reported good correlation, but a larger sample would be needed for validation.Advances in knowledge:The initial findings showed a significant gender difference in benign thyroid uptake parameters at our centre, highlighting the potential need for gender consideration when planning ¹³¹IU patient management and when reporting studies results.     

Clinical evaluation of thyroid CT values in various thyroid conditions.

CT scans of the thyroid were performed with a Hitachi CT-W2 device. The CT value of the region of interest (ROI) was obtained from CT images of the thyroid. Mean and standard deviation was 112 +/- 10 in 44 normals. Out of 27 cases of hyperthyroidism, the CT value of 13 untreated cases of 58 +/- 4, and that of 13 cases under treatment was 73 +/- 7 in average. The CT value of the single cured case was 100. Twelve cases of chronic thyroiditis and 5 cases of hypothyroidism showed averages of 57 +/- 11 and 36 +/- 13, respectively. The results of the above-mentioned clinical study indicate the estimation of the CT value of the thyroid is useful for diagnosis of various thyroid conditions.     

甲状腺腔镜下手术与常规手术对比研究

 目的 探讨甲状腺腔镜下手术优缺点和可行性.方法 应用腔镜下甲状腺手术150例与常规甲状腺手术125例,在手术时间、出血量、术后创面引流量、术后进食时间、镇痛药应用例数、住院时间、美容满意度和住院费进行对比分析.结果 腔镜组与常规组手术时间(h)、出血量(ml)、术后创面引流量(ml)分别为(140.8±52.7)、(132.4±51.1),(60.4±10.3)、(62.3±11.7),(89.3±20.47)、(87.5±19.87),无显著差异(P>0.05);在术后进食时间(h)、镇痛剂应用例数(n)、住院时间(d)、美容满意度(%)、住院费(元)分别为(11.5±3.8)、(21.6±5.1),差异显著(P<0.05);(25)、(84),差异非常显著(P<0.01);(8.86±2.7)、(12.9±3.5),差异显著(P<0.05);(98.5)、(15.3),差异非常显著(P<0.01);(7909.8±1935.2)、(5841.1±1258.6),差异显著 (P<0.05).结论 腔镜下甲状腺手术是一种痛苦小、恢复快、美容佳、安全可行的手术方法.