摘要
异位甲状腺(ETG)是正常解剖位置之外的甲状腺组织,多发生于胸部,临床症状与其位置以及其对邻近结构的影响有关。ETG影像学检查中,甲状腺高锝酸盐(99TcmO4-)单光子发射计算机断层扫描(SPECT)核素显像是定位、定性最常用的方法,功能正常的ETG表现为相应部位放射性高摄取,对于难以鉴别的舌根部和甲状腺舌骨部位肿物,则需要更具有甲状腺组织摄取特异性的131I或123I显像。ETG在计算机断层扫描(CT)和磁共振成像(MRI)中表现多样,大多为不规则软组织密度肿块,边界清楚,密度不均匀,其内有低密度囊变或高密度钙化灶,增强呈不均匀或均匀强化。超声中ETG以低回声为主,部分表现为囊实性回声,腺体内血流信号多丰富。无症状ETG患者通常无须治疗,有症状者常需手术切除,预后良好。术前应结合相关检查,尽可能明确肿物性质,避免因误诊误切导致的甲状腺功能永久性减退。
Ectopic thyroid(ETG)is a thyroid tissue located outside the normal anatomical position,often occurring in the chest.Clinical symptoms are related to its location and its impact on adjacent structures.In ETG imaging examination,single photon emission computed tomography(SPECT)nuclide imaging of thyroid perchlorate(99TcmO4-)is the most commonly used method for localization and characterization.ETG with normal function shows high radiation uptake in the corresponding area.For difficult to distinguish tumors in the base of the tongue and the thyrohyoid region,131I or 123I imaging with more specificity for thyroid tissue uptake is needed.ETG exhibits a variety of manifestations in computed tomography(CT)and magnetic resonance imaging(MRI),mostly irregular soft tissue density masses with clear boundaries and uneven density.There are low-density cystic changes or high-density calcifications within the masses,with uneven or uniform enhancement.In ultrasound,ETG is mainly hypoechoic,with some showing cystic solid echoes and abundant blood flow signals within the gland.Asymptomatic ETG patients usually do not require treatment,while symptomatic patients often require surgical resection and have a good prognosis.Before surgery,relevant examinations should be combined to clarify the nature of the tumor as much as possible,to avoid permanent hypothyroidism caused by misdiagnosis and misresection.
作者
孙昕瑶
黄文鹏
宋乐乐
康磊
Sun Xinyao;Huang Wenpeng;Song Lele;Kang Lei(Department of Nuclear Medicine,Peking University First Hospital,Beijing 100034,China)
出处
《中国医师杂志》
CAS
2023年第12期1900-1904,共5页
Journal of Chinese Physician
基金
国家自然科学基金(82171970、81871385)
北京市杰出青年科学基金项目(JQ21025)
首都临床特色应用研究专项基金(Z221100007422027)
北大医学青年科技创新发展平台青年培育基金(BMU2022PY006)。
关键词
异位甲状腺
放射性核素显像
磁共振成像
Ectopic thyroid
Radionuclide imaging
Magnetic resonance imaging
