Document Detail


Multidetector computed tomography in the preoperative evaluation of retrosternal goiters: a useful procedure for patients for whom magnetic resonance imaging is contraindicated.
MedLine Citation:
PMID:  20151825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Diagnostic imaging provides useful anatomical and morphological information of cervico-mediastinal goiters. The aim of this study was to assess the usefulness of multidetector computed tomography (MDCT) with multiplanar reformatting and volume rendering reconstructions for the preoperative evaluation of retrosternal goiters in patients for whom magnetic resonance imaging is contraindicated. METHODS: From March 2006 to January 2009, 34 patients (20 women and 14 men; mean age, 48 years; range, 42-74 years) with suspected cervico-mediastinal goiter were assessed by MDCT after intravenous injection of contrast material. The following parameters were evaluated: morphology, size, and enhancement of thyroid lobes; presence, location, and mediastinal extension of thyroid tissue; and relations with mediastinal vessels and organs. All patients underwent thyroidectomy. A reference group of 34 patients evaluated by single-detector computed tomography was created. The two groups of patients were compared searching for operative time (OT, in hours), hospital stay (HS, in days), and morbidity rate observed after thyroid surgery in all cases. RESULTS: In 29/34 patients, thyroid was enlarged with left mediastinal extension in 12 cases, right extension in 10 cases, and posterior extension in 7 cases. In 3/34 patients, a normal cervical thyroid connected to the mediastinal goiter through a thin parenchymal stripe was observed. In 2/34 patients, thyroid lobes were enlarged, without mediastinal extension. By comparing the two groups of patients for OT and HS values, a significant reduction to 3.7 +/- 0.1 hours and 4.3 +/- 0.1 days, respectively, was found in the group of MDCT patients, and also a trend to the reduction for morbidity rate (21%) could be recognized. CONCLUSIONS: MDCT represents a noninvasive tool in the evaluation of retrosternal goiters. High-quality multiplanar reformatting and volume rendering reconstructions allow an optimal analysis of the plunged gland and could reduce OT, HS, and probably the morbidity rate.
Authors:
Marco Moschetta; Amato A Stabile Ianora; Mario Testini; Michele Vacca; Arnaldo Scardapane; Giuseppe Angelelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  20     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-7     Citation Subset:  IM    
Affiliation:
Section of Radiology, Department of Internal Medicine and Public Medicine, University of Bari Medical School, Bari, Italy. marco.moschetta@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Goiter, Substernal / radiography*
Humans
Length of Stay
Magnetic Resonance Imaging / contraindications
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed / methods*

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