Современные методы диагностики и срочные оперативные вмешательства при компрессии магистральных сосудов загрудинными узловыми образованиями щитовидной железы

When 25 patients with neck-substernal palpable abnormalities of thyroid gland were examined duplex scanning was performed, as well as multispiral computer tomography of carotid arteries and inner jugular veins. 7 patients had III degree of thyroid gland increase in accordance with Nikolaev, 15 of them IV degree and 3 of them V. Clinical application of the mentioned methods allowed to distinctly visualize the part of node which was behind the sternum and influenced vessels in extravasal way. This influence on the wall of carotid artery in the case of 22 patients caused deviation of the vessel path from its anatomic trajectory, its shift and deformation. In the case of two patients common carotid artery behind the sternum turned out to be compressed and narrowed. Compression of inner jugular vein led to distortion of its vessel geometry, narrowing and deformation. All 25 patients underwent operations, part of them had severe traits of urgent compression syndrome. The operation was performed to the extent of thyroidectomy. When the compression was eliminated 12 patients’ carotid arteries got a straightforward path, it became possible to eliminate the arteries and jugular veins narrowing.