摘要
目的探讨CT对结节性甲状腺肿合并甲状腺癌的鉴别诊断作用。方法回顾性分析36例经手术病理证实的结节性甲状腺肿合并甲状腺癌患者的CT表现。结果 33例乳头状癌、2例未分化癌,1例髓样癌;18例淋巴结转移。CT平扫35例癌灶形态不规则,29例边缘不清晰,5例突破包膜;23例癌灶纵横比>1;28例癌灶为低密度,癌灶内钙化17例,11例砂砾样钙化,12例钙化位于病灶中心;增强扫描36例癌灶不均匀强化,4例囊变中可见中等强化壁结节,13例癌灶边界较平扫模糊。4例侵犯周围组织,6例发现颈部转移淋巴结>10 mm。结论结节性甲状腺肿合并甲状腺癌CT征象相比于单纯性甲状腺癌无特异性CT表现,根据结节的边缘、形态、纵横比、钙化、平扫及增强密度、与周围组织关系、淋巴结增大情况综合分析,能提高甲状腺肿疾病中合并甲状腺癌诊断正确率,降低漏诊率。
Objective To investigate the effect of CT on differential diagnosis of nodular goiter with thyroid carcinoma. Methods A retrospective analysis of 36 cases of nodular goiter with thyroid carcinoma confirmed by pathology was done. Results CT showedthat pathological results were 33 cases of papillary carcinoma,2 cases of undifferentiated carcinoma,1 case of spinal cord mucoepidermoid carcinoma,and 18 cases of lymph node metastasis. In CT,scan in 35 cases of cancer and 29 cases of irregular shape,the edge was not clear,5 cases of break through the envelope and 23 cases of cancer breakthrough capsule; aspect ratio 〉 1; 28 cases of cancer were low density and tumor calcification in 17 cases,11 cases of gravel like calcification,12 cases of calcification in lesions center; enhanced CT scanning in 36 cases of cancer heterogeneous enhancement,4 patients with cystic,13 patients with wall nodules seen in moderate enhancement. Tumor boundary scan was fuzzy. 4 cases had inroads in surrounding tissue,and 6 cases had cervical lymph node metastasis 〉 10 mm. Conclusion There is no specificity in nodular goiter with thyroid cancer CT in simple signs of thyroid gland. According to the nodule edge,comprehensive analysis of shape,aspect ratio,calcification,plain and enhanced density,relationship with surrounding tissue and lymph node enlargement can improve the correct rate of diagnosis of thyroid carcinoma with thyroid disease,and reduce the rate of misdiagnosis.
作者
梁坚豪
朱新进
庞力沛
于芬
梁结玲
LIANG Jian-hao ZHU Xin-jin PANG Li-pei et al(Department of Radiology, Foshan Hospital of Southern Medical University/Foshan Second People＇s Hospital, Foshan, Guangdong, 528000, Chin)
出处
《黑龙江医学》
2017年第6期542-544,共3页
Heilongjiang Medical Journal
