The Evaluation Of Residual Thyroid Volume By CT Three-dimensional Reconstruction And Its Clinical Application

Objective:Thyroid cancer is a common malignant tumor of the endocrine system,and in the past few decades,with the widely application of the thyroid ultrasound,ultrasonic diagnosis technology,makes the thyroid cancer detection rate increased significantly.Among these,the differentiated thyroid cancer is the most common.For the treatment of differentiated thyroid cancer,at present,it is now recognized on the basis of the thyroidectomy surgery postoperative adjuvant Ⅰ131 treatment.But now it is high incidence of thyroid cancer surgery again.The patient s neck structure has canged after the first neck surgery,resulting in residual thyroid positioning is difficult.Besides for the appropriate postoperative adjuvant Ⅰ131,the Ⅰ131 dosing activity("dose")is usually based on residual thyroid volume.At present,the residual thyroid volume date often obtained by thyroid ultrasound.And the neck CT(Computed Tomography,CT)imaging technology has been as a thyroid disease preoperative routine inspection method.The evaluation of residual thyroid volume under neck CT 3d reconstruction whether also has its accuracy,there is no researches.This study is a preliminary explore to the accuracy of neck CT 3d reconsrtruction in evaluating the residual thyroid volume,providing a reliable theoretical basis for calculating radioactive Ⅰ131 dose.Besides,the neck CT 3d reconstruction technique was applied in a case of huge thyroidectomy surgery,to expand the neck CT three-dimensional reconstruction technology in the clinical application scope.Methods:Througha retrospective analysis of 17 patients data who obtained the residual thyroid gland lobectomy in our hospital in February 2017 to March 2018,compare to patients residual thyroid volume by preoperative ultrasound and intraoperative residual thyroid specimens,by preoperative neck CT 3d reconstruction and intraoperative residual thyroid specimens.With the application of statistical software for data analysis,we can obtained the conclusion.At the same time,the neck 3d reconstruction was applied in the case of giant thyroidectomy to evaluate its clinical value in the thyroid surgery.Results:Through the analysis of these date,comparing to the specimens,the residual thyroid differences on the maximum up and down diameter,fore and aft diameter under preoperative ultrasound had the statistically significant(P<0.05).The residual thyroid differences on the maximum left and right diameter under preoperative ultrasound had no statistical significant(P>0.05).The residual thyroid differences on the maximum up and down diameter,fore and aft diameter,left and right diameter under the neck CT 3d reconstruction had no statistical significant(P>0.05).At the same time,under the guidance of 3d reconstruction,surgeons can quickly find and identify the residual thyroid tissue during operation.In the case of giant thyroid surgery,neck CT 3d reconstruction technology can provide the detailed information of internal cervical tissue structure for surgeons before operation.Conclusion:Ultrasound has an error in the assessment of the residual thyroid volume,and the neck CT 3d reconstruction technology has the accuracy in the assessment of the residual thyroid volume,which can provide a reliable theoretical basis for calculating the I131 dose after radical thyroidectomy.At the same time,compared to the ultrasound,the neck CT 3d reconstruction can also provide more space structure of the neck.The surgeons can understand the thyroid size,location and the adjacent structure information.It has the significance in residual thyroidectomy and giant thyroid surgery,playing a significant role in planning operation.