Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypo...Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.展开更多
In this paper, the joint imaging of 99mTcO4- and 99mTc-methoxy isobutyl isonitrile was compared with neck Color Doppler Ultrasonography (CDU) to identify its value in thyroid carcinoma, postoperative recurrence or cer...In this paper, the joint imaging of 99mTcO4- and 99mTc-methoxy isobutyl isonitrile was compared with neck Color Doppler Ultrasonography (CDU) to identify its value in thyroid carcinoma, postoperative recurrence or cervical metastases. Thyroid carcinoma patients (150 operated and 21 re-operated with suspected postoperative recurrence or cervical metastases) were retrospectively analyzed. Taking the pathological result as the gold standard, the thyroid foci (437 cases), the thyroid foci of ≥1-cm diameter (215 cases) and the suspected postoperative recurrence or cervical metastases (87 cases) were compared by diagnostic results of the joint imaging and the neck CDU. The sensitivity, specificity and accuracy of the joint imaging were 64.18%, 80.00% and 67.82%, and 44.78%, 40.00% and 43.68%, respectively, for the cases with suspected postoperative recurrence or cervical metastases. For thyroid carcinoma of ≥1-cm diameter, the sensitivity of the joint imaging was 97.75%, and the neck CDU was 89.89%, but both specificity and accuracy was similar for thyroid carcinoma independence on their diameter. For thyroid carcinoma, the sensitivity of the joint imaging was 81.99%, and the neck CDU was 89.10%. The results show that the joint imaging is sensitive for large diameter thyroid carcinoma.展开更多
患者女,56岁,因“双侧甲状腺乳头状癌”接受“甲状腺全切术+颈部淋巴结清扫术”后1月余;检出糖尿病3个月。查体:颈前见横向手术瘢痕,余未见明显异常。实验室检查:促甲状腺素(thyroid stimulating hormone,TSH)92.72μIU/ml,血清刺激性...患者女,56岁,因“双侧甲状腺乳头状癌”接受“甲状腺全切术+颈部淋巴结清扫术”后1月余;检出糖尿病3个月。查体:颈前见横向手术瘢痕,余未见明显异常。实验室检查:促甲状腺素(thyroid stimulating hormone,TSH)92.72μIU/ml,血清刺激性甲状腺球蛋白(thyroglobulin,Tg)>479ng/ml。行^(131)I清除残余甲状腺组织(简称清甲)治疗后全身显像(^(131)I post therapy whole body scan,Rx-WBS)见颈部多发淋巴结及双肺多发结节^(131)I浓聚。展开更多
Goal: To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childh...Goal: To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy is correlated with a lower quality of life in young people.展开更多
Objective： The aim of this study was to compare the effect of 131I therapy of different clinical stages in postopera- tive patients with papillary thyroid carcinoma （PTC）. Methods： Eighty-seven PTC patients after ...Objective： The aim of this study was to compare the effect of 131I therapy of different clinical stages in postopera- tive patients with papillary thyroid carcinoma （PTC）. Methods： Eighty-seven PTC patients after surgery ablated with high doses of 131I from 2004 to 2010 were retrospectively reviewed. The efficacy of 131I therapy was assessed by three diagnostics that serum thyroglobulin （Tg） was normal or significantly reduced, 131I whole body scan （131I-WBS） was negative or the metas- tases shrank or the number of them decreased and new metastases was not found in cervical ultrasound examination. The x2 test was used to analyze 3 factors which might affect the therapeutic efficacy of 131I in patients of different clinical period, including different surgical ways （total or subtotal thyroidectomy along with half or double sides neck lymph node dissection）, age （〈 45 years and 〉 45 years） and ablative 131I dose. Results： Of 87 patients, the effective rate of 46 patients I stage was 89.13% （41）; the effective rate of 22 cases III stage was 77.27% （17）; the effective rate of 19 cases IV stage was 36.84% （7）. The corresponding intra-groups statistical difference of 3 stages was significant by x2 test （x2 = 1.72, 19.03, 6.87; P 〉 0.25, P 〈 0.005, P 〈 0.01）. The effective rate was 91.67% （44） in 48 cases undergoing total thyroidectomy; the effective rate was 53.85% （21） in 39 patients undergoing subtotal thyroidectomy. There was a significant difference between the two groups above by x2 test （x2 = 16.291; P 〈 0.005）. Conclusion： The efficacy of 131I ablation of stage I and stage III in postoperative PTC patients was almost alike, while the efficacy of stage IV descended markedly. The results was mainly determined by residual thyroid tissue size because of different surgical modus.展开更多
目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例...目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例;年龄39~51岁,平均年龄45.23岁;病理类型,乳头状癌105例,滤泡性腺瘤17例;单侧切除术46例,双侧切除术76例。按照随机数表法将患者分为对照组和研究组,对照组患者行常规甲状腺癌手术,研究组患者在NIRAF技术辅助下行甲状腺切除术。比较两组患者甲状旁腺识别率、围术期指标、氧化应激指标、甲状腺功能、血钙、甲状旁腺激素(PTH)、免疫功能和并发症等参数。结果 研究组患者伤口长度、术中出血量、手术时间、术后引流量和住院时间与对照组比较,差异无统计学意义(P> 0.05)。两组患者均出现感染、发音困难和声音嘶哑等并发症,但差异无统计学意义(P> 0.05),而研究组患者术后低血钙和PTH减退比例明显低于对照组(22.95%vs 44.26%,6.56%vs 19.67%。P=0.013、0.032)。术后7 d两组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显提高,两组患者CD3^(+)CD8^(+)水平明显降低,且研究组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显高于对照组(43.83±4.59 vs 40.23±3.78,1.93±0.21 vs 1.73±0.13。P=0.000、0.000),研究组患者CD3^(+)CD8^(+)水平明显低于对照组(22.61±2.31 vs 23.81±2.62。P=0.008)。术后7 d两组患者血钙和PTH明显降低,且研究组患者血钙和PTH明显高于对照组(2.26±0.18 vs 2.15±0.25,36.98±5.16 vs 27.28±4.99。P=0.000、0.000)。研究组患者甲状腺被膜解剖前检出率为56.19%,明显高于对照组的31.19%(P=0.000);研究组患者甲状旁腺总检出率和总体准确度与对照组比较,差异无统计学意义(P> 0.05)。结论 NIRAF技术辅助识别甲状旁腺组织,可有效提高甲状腺被膜解剖前检出率,减小血钙和PTH减退幅度,增强术后甲状旁腺保护,改善免疫机能,值得临床进一步研究并推广。展开更多
基金Supported by The 2024 Hospital Research Funding,No.KYQ2024008.
文摘Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.
基金Supported by Nature Science Foundation of Jilin Province(No.200705277)
文摘In this paper, the joint imaging of 99mTcO4- and 99mTc-methoxy isobutyl isonitrile was compared with neck Color Doppler Ultrasonography (CDU) to identify its value in thyroid carcinoma, postoperative recurrence or cervical metastases. Thyroid carcinoma patients (150 operated and 21 re-operated with suspected postoperative recurrence or cervical metastases) were retrospectively analyzed. Taking the pathological result as the gold standard, the thyroid foci (437 cases), the thyroid foci of ≥1-cm diameter (215 cases) and the suspected postoperative recurrence or cervical metastases (87 cases) were compared by diagnostic results of the joint imaging and the neck CDU. The sensitivity, specificity and accuracy of the joint imaging were 64.18%, 80.00% and 67.82%, and 44.78%, 40.00% and 43.68%, respectively, for the cases with suspected postoperative recurrence or cervical metastases. For thyroid carcinoma of ≥1-cm diameter, the sensitivity of the joint imaging was 97.75%, and the neck CDU was 89.89%, but both specificity and accuracy was similar for thyroid carcinoma independence on their diameter. For thyroid carcinoma, the sensitivity of the joint imaging was 81.99%, and the neck CDU was 89.10%. The results show that the joint imaging is sensitive for large diameter thyroid carcinoma.
文摘患者女,56岁,因“双侧甲状腺乳头状癌”接受“甲状腺全切术+颈部淋巴结清扫术”后1月余;检出糖尿病3个月。查体:颈前见横向手术瘢痕,余未见明显异常。实验室检查:促甲状腺素(thyroid stimulating hormone,TSH)92.72μIU/ml,血清刺激性甲状腺球蛋白(thyroglobulin,Tg)>479ng/ml。行^(131)I清除残余甲状腺组织(简称清甲)治疗后全身显像(^(131)I post therapy whole body scan,Rx-WBS)见颈部多发淋巴结及双肺多发结节^(131)I浓聚。
文摘Goal: To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy is correlated with a lower quality of life in young people.
文摘Objective： The aim of this study was to compare the effect of 131I therapy of different clinical stages in postopera- tive patients with papillary thyroid carcinoma （PTC）. Methods： Eighty-seven PTC patients after surgery ablated with high doses of 131I from 2004 to 2010 were retrospectively reviewed. The efficacy of 131I therapy was assessed by three diagnostics that serum thyroglobulin （Tg） was normal or significantly reduced, 131I whole body scan （131I-WBS） was negative or the metas- tases shrank or the number of them decreased and new metastases was not found in cervical ultrasound examination. The x2 test was used to analyze 3 factors which might affect the therapeutic efficacy of 131I in patients of different clinical period, including different surgical ways （total or subtotal thyroidectomy along with half or double sides neck lymph node dissection）, age （〈 45 years and 〉 45 years） and ablative 131I dose. Results： Of 87 patients, the effective rate of 46 patients I stage was 89.13% （41）; the effective rate of 22 cases III stage was 77.27% （17）; the effective rate of 19 cases IV stage was 36.84% （7）. The corresponding intra-groups statistical difference of 3 stages was significant by x2 test （x2 = 1.72, 19.03, 6.87; P 〉 0.25, P 〈 0.005, P 〈 0.01）. The effective rate was 91.67% （44） in 48 cases undergoing total thyroidectomy; the effective rate was 53.85% （21） in 39 patients undergoing subtotal thyroidectomy. There was a significant difference between the two groups above by x2 test （x2 = 16.291; P 〈 0.005）. Conclusion： The efficacy of 131I ablation of stage I and stage III in postoperative PTC patients was almost alike, while the efficacy of stage IV descended markedly. The results was mainly determined by residual thyroid tissue size because of different surgical modus.
文摘目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例;年龄39~51岁,平均年龄45.23岁;病理类型,乳头状癌105例,滤泡性腺瘤17例;单侧切除术46例,双侧切除术76例。按照随机数表法将患者分为对照组和研究组,对照组患者行常规甲状腺癌手术,研究组患者在NIRAF技术辅助下行甲状腺切除术。比较两组患者甲状旁腺识别率、围术期指标、氧化应激指标、甲状腺功能、血钙、甲状旁腺激素(PTH)、免疫功能和并发症等参数。结果 研究组患者伤口长度、术中出血量、手术时间、术后引流量和住院时间与对照组比较,差异无统计学意义(P> 0.05)。两组患者均出现感染、发音困难和声音嘶哑等并发症,但差异无统计学意义(P> 0.05),而研究组患者术后低血钙和PTH减退比例明显低于对照组(22.95%vs 44.26%,6.56%vs 19.67%。P=0.013、0.032)。术后7 d两组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显提高,两组患者CD3^(+)CD8^(+)水平明显降低,且研究组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显高于对照组(43.83±4.59 vs 40.23±3.78,1.93±0.21 vs 1.73±0.13。P=0.000、0.000),研究组患者CD3^(+)CD8^(+)水平明显低于对照组(22.61±2.31 vs 23.81±2.62。P=0.008)。术后7 d两组患者血钙和PTH明显降低,且研究组患者血钙和PTH明显高于对照组(2.26±0.18 vs 2.15±0.25,36.98±5.16 vs 27.28±4.99。P=0.000、0.000)。研究组患者甲状腺被膜解剖前检出率为56.19%,明显高于对照组的31.19%(P=0.000);研究组患者甲状旁腺总检出率和总体准确度与对照组比较,差异无统计学意义(P> 0.05)。结论 NIRAF技术辅助识别甲状旁腺组织,可有效提高甲状腺被膜解剖前检出率,减小血钙和PTH减退幅度,增强术后甲状旁腺保护,改善免疫机能,值得临床进一步研究并推广。
