Assessment of compression syndrome with increase in thyroid gland volume

Abstract

Objective. To determine the criteria for compression syndrome with an increase in the volume of the thyroid gland according to magnetic resonance imaging (MRI) of the soft tissues of the neck.

Materials and methods. Magnetic resonance tomograms of 62 patients with normal thyroid volume (thyroid gland) (group 1) and 89 patients with thyromegaly (group 2) were analyzed. At the same time, the width, height, antero-posterior size of the lobes and isthmus of the thyroid gland, displacement of the trachea, esophagus, carotid artery, jugular vein and the distance between some neck structures were measured. The results obtained were compared in the groups. The differentiating informativeness of each parameter was characterized by a Kullback measure.

Results. On the basis of MRI of the soft tissues of the neck, quantitative compression criteria, diagnostic coefficients and thresholds for the probability of compression in patients with thyroid pathology were determined. Summing up the diagnostic coefficients of each parameter, it was possible to identify a compression syndrome with a given probability. With the sum of diagnostic coefficients 61 and higher, compression of the neck organs is diagnosed with a probability of 95 %, with – minus 32 points or less, compression is absent with a probability of 95 %. The interval of the diagnostic coefficient from 29 to 61 corresponds to the presence of compression syndrome with a probability of 94 % to 55 %, respectively. With a diagnostic coefficient in the range from 25 to -32, the probability of compression of the neck organs is from 5 % to 45 %. Patients with the sums of diagnostic coefficients from 26 to 28 are in the zone of "diagnostic uncertainty" that implies dynamic observation.

Conclusions. The use of the proposed method for assessing the compression syndrome with an increase in the thyroid gland allows you to objectively identify its presence or absence.

Keywords

thyroid gland / thyroidectomy / magnetic resonance imaging / compression syndrome

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