Abstract：
OBJECTIVE: The present study aimed to investigate CT imaging features, pathological findings, and prognosis in patients with thyroid hemiatrophy (THA) associated with papillary thyroid carcinoma (PTC).
METHODS: This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA.
RESULTS: THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups.
CONCLUSIONS: THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.
METHODS: This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA.
RESULTS: THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups.
CONCLUSIONS: THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.
摘要：
目的：本研究旨在探讨CT影像学特征，病理结果，与甲状腺乳头状癌（PTC）相关的甲状腺偏侧萎缩（THA）患者的预后。
方法：这项回顾性研究包括225例经手术切除的组织病理学证实的PTC患者，他们接受了术前CT扫描。在CT图像上,THA被定义为PTC同侧的甲状腺实质萎缩。CT检查结果,总生存率,比较有和没有THA的患者的无病生存率。在有和没有THA的PTC中也评估了病理学发现。
结果：在225例PTC患者中有35例（16％）观察到THA。在20例患者的右叶（57％）和其余15例患者的左叶（43％）中观察到萎缩性甲状腺实质。关于PTC内的固体组分，对比增强CT衰减(114.2±18.2vs.126.7±31.3HU；p<0.05），对比增强CT减去未增强CT的CT衰减变化（60.2±18.1vs.72.3±31.0HU；p<0.05）在有THA的PTC中明显低于无THA的PTC。组织病理学,几乎所有患有THA的PTC（97％）都有瘢痕疙瘩样胶原蛋白，这是广泛的低细胞胶原束，具有明亮的嗜酸性细胞性透明质化，通常在瘢痕疙瘩中观察到。然而,两组间的预后无显著差异.
结论：在PTC患者中偶尔观察到THA。弱对比增强是PTC患者THA的显著特点，这可能是由瘢痕疙瘩样胶原蛋白引起的。
方法：这项回顾性研究包括225例经手术切除的组织病理学证实的PTC患者，他们接受了术前CT扫描。在CT图像上,THA被定义为PTC同侧的甲状腺实质萎缩。CT检查结果,总生存率,比较有和没有THA的患者的无病生存率。在有和没有THA的PTC中也评估了病理学发现。
结果：在225例PTC患者中有35例（16％）观察到THA。在20例患者的右叶（57％）和其余15例患者的左叶（43％）中观察到萎缩性甲状腺实质。关于PTC内的固体组分，对比增强CT衰减(114.2±18.2vs.126.7±31.3HU；p<0.05），对比增强CT减去未增强CT的CT衰减变化（60.2±18.1vs.72.3±31.0HU；p<0.05）在有THA的PTC中明显低于无THA的PTC。组织病理学,几乎所有患有THA的PTC（97％）都有瘢痕疙瘩样胶原蛋白，这是广泛的低细胞胶原束，具有明亮的嗜酸性细胞性透明质化，通常在瘢痕疙瘩中观察到。然而,两组间的预后无显著差异.
结论：在PTC患者中偶尔观察到THA。弱对比增强是PTC患者THA的显著特点，这可能是由瘢痕疙瘩样胶原蛋白引起的。
