颈部CT三维重建与超声评估残留甲状腺体积的准确性比较
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摘要
目的对比研究颈部CT三维重建与超声在评估残留甲状腺体积中的准确性。方法回顾性分析17例(共21个残留甲状腺腺叶)2017年2月～2018年3月于我院普通外科行残留甲状腺腺叶切除术患者的临床资料,分别对比患者术前超声残留甲状腺体积与术中残留甲状腺实体标本所测体积、术前三维CT重建下所测甲状腺体积与术中残留甲状腺实体标本所测体积。结果与术中实体标本所测残留甲状腺体积数据对比,术前超声所测残留甲状腺体积在最大上下径、最大前后径上的差异有统计学意义(P<0.05),在最大左右径上的差异无统计学意义(P>0.05),颈部CT三维重建下所测的残留甲状腺体积在最大上下径、最大左右径、最大前后径上的差异均无统计学意义(P>0.05)。结论超声在对残留甲状腺体积的评估上存在一定的误差,而颈部CT三维重建技术在评估残留甲状腺体积中更加准确,可为临床计算甲状腺癌术后I~(131)治疗剂量提供更可靠的理论依据。
Objective To compare the accuracy of three-dimensional reconstruction of cervical CT and ultrasound for estimating residual thyroid volume. Methods We performed a retrospective analysis of 17 patients with 21 residual thyroid glands undergoing thyroidectomy surgery between February, 2017 and March, 2018 in our department. We compared the residual thyroid volume in preoperative ultrasound with the intraoperative measurement and the volume measured using threedimensional CT reconstruction before surgery. Results The maximum vertical and anterioposterior diameters of the residual thyroid measured by preoperative ultrasound differed significantly from the volume data measured intraoperatively(P<0.05),but the difference in the maximum left-right diameters was not statistically significant(P>0.05). The maximum vertical, leftright, and anteroposterior diameters estimated by three-dimensional reconstruction of cervical CT was all similar with those measured intraoperatively(P>0.05). Conclusion Compared with ultrasound examination, three-dimensional reconstruction of neck CT is more accurate for estimating the residual thyroid volume and provides more reliable evidence for clinical calculation of postoperative I~(131) dose for thyroid cancer.
Objective To compare the accuracy of three-dimensional reconstruction of cervical CT and ultrasound for estimating residual thyroid volume. Methods We performed a retrospective analysis of 17 patients with 21 residual thyroid glands undergoing thyroidectomy surgery between February, 2017 and March, 2018 in our department. We compared the residual thyroid volume in preoperative ultrasound with the intraoperative measurement and the volume measured using threedimensional CT reconstruction before surgery. Results The maximum vertical and anterioposterior diameters of the residual thyroid measured by preoperative ultrasound differed significantly from the volume data measured intraoperatively(P<0.05),but the difference in the maximum left-right diameters was not statistically significant(P>0.05). The maximum vertical, leftright, and anteroposterior diameters estimated by three-dimensional reconstruction of cervical CT was all similar with those measured intraoperatively(P>0.05). Conclusion Compared with ultrasound examination, three-dimensional reconstruction of neck CT is more accurate for estimating the residual thyroid volume and provides more reliable evidence for clinical calculation of postoperative I~(131) dose for thyroid cancer.
引文
[1]徐建.医学影像三维重建系统的实现探讨[J].影像技术, 2017, 29(4):69-72.
[2] Guo J, Qian J, Yuan YF. Computed tomography measurements as a standard of exophthalmos? two-dimensional versus three-dimensional techniques[J]. Curr Eye Res, 2018, 43(5):647-53.
[3] Inokuchi H, Tojima M, Mano H, et al. Neck range of motion measurements using a new three-dimensional motion analysis system:validity and repeatability[J]. Eur Spine J, 2015, 24(12):2807-15.
[4] Lee SJ, Chong SM, Kang KH, et al. Semiautomated thyroid volumetry using 3D CT:prospective comparison with measurements obtained using 2D ultrasound, 2D CT, and water displacement method of specimen[J]. Am J Roentgenol, 2014, 203(5):W525-32.
[5] Freesmeyer M, Wiegand S, Schierz J, et al. Multimodal evaluation of2-D and 3-D Ultrasound, Computed tomography and magnetic resonance imaging in measurements of the thyroid volume using universally applicable cross-sectional imaging software:a phantom study[J]. Ultras Med Biol, 2014, 40(7):1453-62.
[6] Cavallo A, Johnson DN, White MG, et al. Thyroid nodule size at ultrasound as a predictor of malignancy and final pathologic size[J].Thyroid, 2017, 27(5):641-50.
[7]费腾,陈亚青.甲状腺癌超声诊断的研究进展[J].中国癌症杂志,2015, 25(4):316-20.
[8] Kim SC, Kim JH, Choi SH, et al. Off-site evaluation of threedimensional ultrasound for the diagnosis of thyroid nodules:comparison with two-dimensional ultrasound[J]. Eur Radiol, 2016,26(10):3353-60.
[9]钱晓芹,夏泽.三维超声体积自动测量系统精确测量甲状腺体积[J].中国医学影像技术, 2009, 25(5):894-6.
[10]Licht K, Darr A, Opfermann T, et al. 3D ultrasonography is as accurate as low-dose CT in thyroid volumetry[J]. Nuklearmedizin,2014, 53(3):99-104.
[11]朱涛,徐浩,田甜,等. 2017年美国预防服务工作组甲状腺癌筛查推荐声明解读[J].肿瘤防治研究, 2018, 45(10):710-4.
[12]胡照洋,张自杰,李长键,等.甲状腺再次手术治疗的临床分析[J].现代生物医学进展, 2017, 17(21):4086-8.
[13]Tokat AO, Akbulut A, Billur D, et al. Montelukast attenuates radioactive I131-induced pulmonary damage on rats[J]. Int J Radiat Biol, 2018, 94(6):542-50.
[14]张莹,段莉莉,高永举.分化型甲状腺癌术后应用131I清除残余甲状腺组织的疗效及影响因素分析[J].中华实用诊断与治疗杂志, 2019,33(2):567-70.
[15]Howard BA, James OG, Perkins JM, et al. A practical method of I-131 thyroid cancer therapy dose optimization using estimated effective renal clearance[J]. SAGE Open Med Case Rep, 2017, 7(5):1-4.
[16]Sacks W, Wong RM, Bresee C, et al. Use of evidence-based guidelines reduces I131 treatment in patients with low risk DifferentiatedThyroid cancer[J]. Thyroid, 2015, 25(4):377-85.
[17]Chan AC, Lang BH, Wong KP. The pros and cons of routine central compartment neck dissection for clinically nodal negative(cNo)papillary thyroid cancer[J]. Gland Surg, 2013, 2(4):186-95.
[18]Yapa S, Mulla O, Green V, et al. The role of chemokines in thyroid carcinoma[J]. Thyroid, 2017, 27(11):1347-59.
[19]Zevallos JP, Hartman CM, Kramer JR, et al. Increased thyroid cancer incidence corresponds to increased use of thyroid ultrasound and fine-needle aspiration:a study of the Veterans Affairs heslth care system[J]. Cancer, 2015, 121(5):741-6.
[20]Yang Z, Flores J, Katz S, et al. Comparison of survival outcomes following postsurgical radioactive Iodine versus external beam radiation in stage IV differentiated thyroid carcinoma[J]. Thyroid,2017, 27(7):944-52.
[21]Daniel FI, Lima LD, Grando LJ, et al. Salivary evaluation in radioactive I-131 treated patients with thyroid carcinoma[J]. Acta Odontol Scand, 2018, 76(2):148-52.
[22]田毅,柳林,李显忠.螺旋CT甲状腺体积测量的可靠性及临床应用[J].临床放射学杂志, 2009, 28(7):933-6.
[23]Shu J, Zhao J, Guo D, et al. Accuracy and reliability of thyroid volumetry using spiral CT and thyroid volume in a healthy, noniodine-deficient Chinese adult populaton[J]. Eur J Radiol, 2011, 77(2):274-80.
[24]蔡念,喻海波,杨景哥,等.甲状腺三维重建在腔镜甲状腺切除术中的应用[J].腹腔镜外科杂志, 2012, 17(6):408-11.
[25]Fan M, Dai PS, Zheng BH, et al. Constructing three-dimensional detachable and composable computer models of the head and neck[J]. Australasian Physical&Engineering Sciences in Medicine,2015, 38(2):271-81.
[26]姜涛,王磊,刘玉芝,等.三维重建结合3D打印技术在腔镜甲状腺手术中的临床应用[J].腹腔镜外科杂志, 2016, 12(21):887-90.
[27]王朝晖,伏桂明,陈锦,等.计算机辅助设计三维可视化技术在侵犯气管的甲状腺癌手术中的应用[J].中华耳鼻咽喉头颈外科杂志,2017, 52(10):774-6.
[28]Zhang L, Hu W, Huang H, et al. The application of CAD/CAM technology on the recostruction of the thyroid cartilage[J]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2014, 28(19):1487-90.
[29]Becker M, Duboe PO, Platon AA, et al. MDCT in the assessment of laryngeal trauma:value of 2D multiplanar and 3D reconstructions[J].Am J Roentgenol, 2013, 201(4):W639-47.
[30]Baba M, Matsumoto K, Yamasaki N, et al. Development of a tailored thyroid gland phantom for fine-needle aspiration cytology by threedimensional printing[J]. J Surg Educ, 2017, 74(6):1039-46.
[2] Guo J, Qian J, Yuan YF. Computed tomography measurements as a standard of exophthalmos? two-dimensional versus three-dimensional techniques[J]. Curr Eye Res, 2018, 43(5):647-53.
[3] Inokuchi H, Tojima M, Mano H, et al. Neck range of motion measurements using a new three-dimensional motion analysis system:validity and repeatability[J]. Eur Spine J, 2015, 24(12):2807-15.
[4] Lee SJ, Chong SM, Kang KH, et al. Semiautomated thyroid volumetry using 3D CT:prospective comparison with measurements obtained using 2D ultrasound, 2D CT, and water displacement method of specimen[J]. Am J Roentgenol, 2014, 203(5):W525-32.
[5] Freesmeyer M, Wiegand S, Schierz J, et al. Multimodal evaluation of2-D and 3-D Ultrasound, Computed tomography and magnetic resonance imaging in measurements of the thyroid volume using universally applicable cross-sectional imaging software:a phantom study[J]. Ultras Med Biol, 2014, 40(7):1453-62.
[6] Cavallo A, Johnson DN, White MG, et al. Thyroid nodule size at ultrasound as a predictor of malignancy and final pathologic size[J].Thyroid, 2017, 27(5):641-50.
[7]费腾,陈亚青.甲状腺癌超声诊断的研究进展[J].中国癌症杂志,2015, 25(4):316-20.
[8] Kim SC, Kim JH, Choi SH, et al. Off-site evaluation of threedimensional ultrasound for the diagnosis of thyroid nodules:comparison with two-dimensional ultrasound[J]. Eur Radiol, 2016,26(10):3353-60.
[9]钱晓芹,夏泽.三维超声体积自动测量系统精确测量甲状腺体积[J].中国医学影像技术, 2009, 25(5):894-6.
[10]Licht K, Darr A, Opfermann T, et al. 3D ultrasonography is as accurate as low-dose CT in thyroid volumetry[J]. Nuklearmedizin,2014, 53(3):99-104.
[11]朱涛,徐浩,田甜,等. 2017年美国预防服务工作组甲状腺癌筛查推荐声明解读[J].肿瘤防治研究, 2018, 45(10):710-4.
[12]胡照洋,张自杰,李长键,等.甲状腺再次手术治疗的临床分析[J].现代生物医学进展, 2017, 17(21):4086-8.
[13]Tokat AO, Akbulut A, Billur D, et al. Montelukast attenuates radioactive I131-induced pulmonary damage on rats[J]. Int J Radiat Biol, 2018, 94(6):542-50.
[14]张莹,段莉莉,高永举.分化型甲状腺癌术后应用131I清除残余甲状腺组织的疗效及影响因素分析[J].中华实用诊断与治疗杂志, 2019,33(2):567-70.
[15]Howard BA, James OG, Perkins JM, et al. A practical method of I-131 thyroid cancer therapy dose optimization using estimated effective renal clearance[J]. SAGE Open Med Case Rep, 2017, 7(5):1-4.
[16]Sacks W, Wong RM, Bresee C, et al. Use of evidence-based guidelines reduces I131 treatment in patients with low risk DifferentiatedThyroid cancer[J]. Thyroid, 2015, 25(4):377-85.
[17]Chan AC, Lang BH, Wong KP. The pros and cons of routine central compartment neck dissection for clinically nodal negative(cNo)papillary thyroid cancer[J]. Gland Surg, 2013, 2(4):186-95.
[18]Yapa S, Mulla O, Green V, et al. The role of chemokines in thyroid carcinoma[J]. Thyroid, 2017, 27(11):1347-59.
[19]Zevallos JP, Hartman CM, Kramer JR, et al. Increased thyroid cancer incidence corresponds to increased use of thyroid ultrasound and fine-needle aspiration:a study of the Veterans Affairs heslth care system[J]. Cancer, 2015, 121(5):741-6.
[20]Yang Z, Flores J, Katz S, et al. Comparison of survival outcomes following postsurgical radioactive Iodine versus external beam radiation in stage IV differentiated thyroid carcinoma[J]. Thyroid,2017, 27(7):944-52.
[21]Daniel FI, Lima LD, Grando LJ, et al. Salivary evaluation in radioactive I-131 treated patients with thyroid carcinoma[J]. Acta Odontol Scand, 2018, 76(2):148-52.
[22]田毅,柳林,李显忠.螺旋CT甲状腺体积测量的可靠性及临床应用[J].临床放射学杂志, 2009, 28(7):933-6.
[23]Shu J, Zhao J, Guo D, et al. Accuracy and reliability of thyroid volumetry using spiral CT and thyroid volume in a healthy, noniodine-deficient Chinese adult populaton[J]. Eur J Radiol, 2011, 77(2):274-80.
[24]蔡念,喻海波,杨景哥,等.甲状腺三维重建在腔镜甲状腺切除术中的应用[J].腹腔镜外科杂志, 2012, 17(6):408-11.
[25]Fan M, Dai PS, Zheng BH, et al. Constructing three-dimensional detachable and composable computer models of the head and neck[J]. Australasian Physical&Engineering Sciences in Medicine,2015, 38(2):271-81.
[26]姜涛,王磊,刘玉芝,等.三维重建结合3D打印技术在腔镜甲状腺手术中的临床应用[J].腹腔镜外科杂志, 2016, 12(21):887-90.
[27]王朝晖,伏桂明,陈锦,等.计算机辅助设计三维可视化技术在侵犯气管的甲状腺癌手术中的应用[J].中华耳鼻咽喉头颈外科杂志,2017, 52(10):774-6.
[28]Zhang L, Hu W, Huang H, et al. The application of CAD/CAM technology on the recostruction of the thyroid cartilage[J]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2014, 28(19):1487-90.
[29]Becker M, Duboe PO, Platon AA, et al. MDCT in the assessment of laryngeal trauma:value of 2D multiplanar and 3D reconstructions[J].Am J Roentgenol, 2013, 201(4):W639-47.
[30]Baba M, Matsumoto K, Yamasaki N, et al. Development of a tailored thyroid gland phantom for fine-needle aspiration cytology by threedimensional printing[J]. J Surg Educ, 2017, 74(6):1039-46.