摘要
目的研究甲状腺癌淋巴结转移的CT特点及其在甲状腺癌的诊断和手术方式选择方面的应用价值。方法回顾性分析经手术及病理诊断的50例甲状腺癌淋巴结转移的CT表现。结果50例中,Ⅱ+Ⅲ区颈淋巴结转移14例,Ⅳ区19例,Ⅴ区1例,Ⅵ9例。43例甲状腺癌淋巴结转移者39例边缘规则。32例乳头状癌中,31例淋巴结明显强化密度与正常甲状腺相似,10例有囊性变,其中8例淋巴结囊内有明显强化的乳头状结节,9例有细颗粒状钙化。11例滤泡癌、髓样癌、未分化癌中,10例淋巴结明显强化,10例与甲状腺原发或复发肿瘤密度一致,密度均匀或不均匀。结论甲状腺癌转移淋巴结好发部位为颈静脉链周围、气管食管沟,淋巴结明显强化、与正常甲状腺密度一致、囊性变、囊壁内明显强化的乳头状结节及细颗粒状钙化为甲状腺乳头状癌的特征性改变,淋巴结明显强化、与甲状腺肿瘤密度一致为滤泡癌、髓样癌、未分化癌转移淋巴结的特点。它有助于甲状腺癌的术前诊断和选择甲状腺癌的手术方式。
Objective To study CT manifestation of lymph node metastasis from thyroid carcinoma and it＇s value in diagnosis of thyroid carcinoma and choice of operation pattern. Method CT appearances of lymph node metastasis from thyroid carcinoma proved by surgery and pathology in 50 patients were reviewed. Results Of these 50 cases,metastatic lymph nodes were located at Ⅱ＋Ⅲ region（n=14）, Ⅳ region （n=19）,Ⅴ region （n=1）, and Ⅵ region （n=9）. Of 43 thyriod carcinoma patients,the borderline of metastatic lymph node was regular （n=39）. Of 32 patients of thyroid papillary carcinoma,the attenuation of metastatic lymph nodes were similar to that of normal thyroid gland（n=31）, with cystic formations （n=10）,intracystic high attenuation papillary- like nodules （n=8）, and fine granular calcifications （n=9）. Of 11 follicular carcinoma,medullary carcinoma,and anaplastic carcinoma patients, 10 cases had significant homogeneous or heterogeneous enhanced nodes, and the attenuation was the same as primary or recurrent thyroid tumors.Conclusions For thyroid carcinoma, the most common locations of metastatic lymph nodes are about internal jugular chain, tracheoesophageal groove regions. Marked enhancement similar to normal thyroid gland,cystic formations with intracystic high attenuation papillary-like nodules, and fine discrete granular calcifications are the characteristic manifestations of metastatic lymph node of papillary carcinoma. Marked homogeneous or heterogeneous enhancement after contrast administration and the same attenuation as the primary or recurrent thyroid tumor are found in follicular carcinoma,medullary carcinoma,and anaplastic carcinoma metastases.These manifestations are helpful to the diagnosis of thyroid carcinoma and choice of surgery procedure.
出处
《实用医药杂志》
2007年第7期779-781,784,共4页
Practical Journal of Medicine & Pharmacy
关键词
甲状腺癌
淋巴结转移
CT
Thyroid carcinoma Cervical lymph node metastasis CT
