Clinical and economic impact of incidental thyroid lesions found with CT and MR.
Clinical and economic impact of incidental thyroid lesions found with CT and MR.
复制标题
CT 和 MR 发现的偶发甲状腺病变的临床和经济影响。
DOI：
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
C. Langlotz
中科院分区：
文献类型：
--
作者：
D. M. Youserm;T. Huang;L. Loevner;C. Langlotz
目的
评估头颈部横断面影像上偶然发现的甲状腺病变的患病率以及治疗策略的临床和经济后果。
方法
回顾性分析了在1年内对因其他目的接受检查的患者进行的200次连续颈部CT扫描和200次连续颈部MR图像，以确定意外甲状腺病变的患病率。在排除既往甲状腺切除术、已知甲状腺疾病和检查不充分的患者后，分析了231项影像学研究。
结果
231例患者中有14例（6%）最初报告了偶发甲状腺病变，但在回顾性审查中发现了另外22例（9.5%），总计近16%（36/231）。36例患者中有6例接受了进一步检查，包括核医学造影（n = 3）、超声检查（n = 3）、甲状腺功能检查（n = 5）、细针穿刺（n = 4）和甲状腺叶切除术（n = 1）。最终的诊断，在四个六名患者，包括三个多结节性甲状腺肿和一个滤泡性腺瘤。两名患者，一个在细针穿刺非诊断结果，第二个与正常的甲状腺功能测试结果，正在跟踪。每名接受检查的患者的平均检查和治疗费用为1158美元。
结论
偶然的甲状腺病变是经常存在的，往往被忽视的横断面图像上的病人正在检查的其他原因。对这些病变进行检查的成本及其在人群中的高患病率提出了关于适当管理策略的问题。
PURPOSE
To estimate the prevalence and the clinical and economic consequences of management strategies for thyroid lesions detected incidentally on cross-sectional imaging of the head and neck.
METHODS
Two hundred consecutive CT scans and 200 consecutive MR images of the neck performed over a 1-year period in patients being examined for other purposes were reviewed retrospectively to determine the prevalence of unexpected thyroid lesions. After excluding patients with prior thyroidectomies, known thyroid disease, and inadequate examinations, 231 imaging studies were analyzed.
RESULTS
Incidental thyroid lesions were originally reported in 14 (6%) of the 231 patients, but an additional 22 (9.5%) were found on retrospective review for a total of nearly 16% (36 of 231). Six of the 36 patients received further workup, consisting of nuclear medicine scintigraphy (n = 3), sonography (n = 3), thyroid function tests (n = 5), fine-needle aspiration (n = 4), and thyroid lobectomy (n = 1). Final diagnoses, obtained in four of the six patients, included three multinodular goiters and one follicular adenoma. Two patients, one with nondiagnostic findings at fine-needle aspiration and a second with normal thyroid function test results, are being followed up. The mean cost of the workup and treatment per examined patient was $1158.
CONCLUSION
Incidental thyroid lesions are frequently present and often overlooked on cross-sectional images of the neck in patients being examined for other reasons. The cost of pursuing a workup of these lesions and their high prevalence in the population raise questions regarding appropriate management strategies.
DOI：
10.1056/nejm199302253280807
发表时间：
1993-02
期刊：
The New England journal of medicine
影响因子：
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作者：
E. Mazzaferri
通讯作者：
E. Mazzaferri
北欧国家不同形态类型甲状腺癌的发病率。
DOI：
10.1111/j.1699-0463.1981.tb00186.x
发表时间：
1981
期刊：
Acta pathologica et microbiologica Scandinavica. Section A, Pathology
影响因子：
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作者：
Franssila,K;Saxen,E;Teppo,L;Bjarnason,O;Tulinius,H;Normann,T;Ringertz,N
通讯作者：
Ringertz,N