摘要目的 探讨颈椎退行性变患者甲状腺异常的MRI检出率及相关影响因素。方法 回顾性研究。纳入2014年10月—2018年4月徐州医科大学附属医院骨科963例颈椎退行性变患者的临床资料,其中男515例、女448例,年龄28~91 （56.0±11.1）岁。统计甲状腺异常患者的检出率、类型。根据是否合并甲状腺异常将患者分为合并甲状腺异常和无甲状腺异常2组,比较2组患者的性别、年龄、体质量指数（BMI）、颈部放射史及甲状腺疾病家族史等临床资料,采用多因素logistic回归分析甲状腺异常发生的影响因素。结果 963例患者中,发现甲状腺异常63例,检出率6.5%。63例甲状腺异常患者中,甲状腺结节47例,甲状腺肿10例,桥本甲状腺炎3例,甲状腺部分切除术术后2例,甲状腺癌1例。900例无甲状腺异常者和63例合并甲状腺异常者2组颈椎退行性变患者比较,在吸烟史方面差异无统计学意义（P>0.05）;在年龄、性别、BMI、颈部放射史及甲状腺疾病家族史等方面差异均有统计学意义（P值均<0.05）。进一步多因素logistic回归分析显示,女性[比值比（OR）=4.640、95%可信区间（CI）2.470~8.719]是甲状腺异常的危险因素,年龄（OR=0.968、95% CI 0.946~0.991）及BMI（OR=0.918、95% CI 0.848~0.993）是甲状腺异常的保护因素（P值均<0.05）。结论 颈椎退行性变患者在颈椎MRI中检出甲状腺异常并不少见,性别、年龄、BMI是甲状腺异常的独立影响因素。临床应重视颈椎MRI中甲状腺区域的判读、评估,尤其是对女性、年龄小、BMI低的患者,完善相关评估,颈椎于术前发现甲状腺异常可降低其潜在的手术风险。
Abstract：Objective This study aims to investigate the incidence, imaging features, and related influencing factors of thyroid abnormalities in patients with cervical spine degeneration. Methods Retrospective research. The clinical data of 963 patients with cervical spine degeneration in the Department of Orthopedics, Affiliated Hospital of Xuzhou Medical University from October 2014 to April 2018 were included, including 515 males and 448 females, aged 28-91 (56.0±11.1) years. The overall incidence and types of patients with thyroid abnormalities were counted. Patients were divided into two groups according to whether there was thyroid abnormality, and clinical data including gender, age, body mass index (BMI), neck radiation history and family history of thyroid disease were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors of thyroid abnormalities. Results Among the 963 patients, 63 thyroid abnormalities were found, with an overall incidence of 6.5%. Among the 63 patients with thyroid abnormalities, 47 patients presented thyroid nodules, 10 patients suffered from goiter, 3 patients were afflicted with Hashimoto's thyroiditis, 2 patients were underwent partial thyroidectomy, and 1 patient was diagnosed with thyroid cancer. The comparison of 900 patients without thyroid abnormalities and 63 patients with cervical spine degeneration and thyroid abnormalities demonstrated that the difference in smoking history is statistically insignificant (P>0.05) and differences in age, sex, BMI, history of neck radiation, and family history of thyroid disease are statistically significant (all P values < 0.05). Further multifactorial logistic regression analysis showed that female (odds ratios [OR]=4.640, 95% credibility interval [CI]=2.470-8.719) was risk factor for thyroid abnormalities, age (OR=0.968, 95% CI=0.946-0.991) and BMI (OR=0.918, 95% CI=0.848-0.993) were protective factors for thyroid abnormalities (all P values < 0.05). Conclusion It is not uncommon to find thyroid abnormalities in cervical MRI in patients with cervical spine degeneration, and gender, age and BMI are independent influencing factors of thyroid abnormalities. The size, number, shape and signal of abnormal thyroid can be clearly displayed on MRI. Clinical attention should be paid to the interpretation and evaluation of thyroid region in cervical MRI, especially for female, young and low BMI patients, so as to improve relevant evaluation, detect thyroid abnormalities as soon as possible and reduce the potential risks.
闫梓文, 郑欣, 黄超然, 潘盛, 李东亚, 彭大霖, 金王亦, 张星晨, 庞勇, 郭开今. 基于颈椎退行性变患者颈部MR影像的甲状腺异常的检出率及影响因素分析[J]. 中华解剖与临床杂志, 2022, 27(7): 475-479.
Yan Ziwen, Zheng Xin, Huang Chaoran, Pan Sheng, Li Dongya, Peng Dalin, Jin Wangyi, Zhang Xingchen, Pang Yong, Guo Kaijin. MRI-based analysis of the incidence and associated factors of cervical degeneration combined with thyroid abnormalities. Chinese Journal of Anatomy and Clinics, 2022, 27(7): 475-479.
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