摘要
目的比较不同大小甲状腺乳头状癌（papillary thyroid carcinoma，PTC）的CT征象，探讨其对PTC的诊断价值。方法回顾分析经组织学证实的396例406枚PTC的CT征象，依据瘤体最大径，将其分为1．1～2．0cm组、2．1～3．0cm组和〉3．0cm组，分析形态不规则、咬饼征、增强后范围缩小／模糊和微钙化在各组瘤体中的分布。结果406枚PTC中，1．1～2．0cm组、2．1～3．0cm组和〉3．0cm组分别为318枚、60枚和28枚，其中形态不规则、咬饼征、增强后范围缩小，模糊和微钙化在各组瘤体中分别占89．6％（285／318）、75．0％（45／60）和64．3％（18，28）；83．6％（266／318）、71．7％（43／60）和64.3％（18／28）；84．0％（267／318）、78.3％（47／60）和67．9％（19／28）；35．5％（113，318）、40．0％（24／60）和59．3％（16／27）。3组瘤体中，形态不规则（χ2=20．092，P=0．000）和咬饼征（r=9．695，P=0．008），差异具有统计学意义，增强后范围缩小／模糊（χ2=5．175，P=0．075）和微钙化（χ2=5．277，P=0．071），差异无统计学意义；进一步对形态不规则和咬饼征进行组内比较，1．1—2．0cm组和2．1—3．0cm（χ2=9．746，P=0．002）组、1．1—2．0cm组和〉3．0cm（χ2=15．180，P=0．000）组在形态不规则上差异均有统计学意义，1．1～2．0cm组和〉3．0cm（χ2=6．560，P=0．010）在咬饼征上差异有统计学意义，余组内比较差异无统计学意义。结论尽管形态不规则、咬饼征、增强后范围缩小／模糊和微钙化是诊断PTC的重要CT征象，但不同征象随瘤体大小而存在一定差异．正确识别这些差异有助于提高PTC术前诊断准确率，减少误诊的发生。
Objective To investigate diagnostic value of CT signs in papillary thyroid carcinoma （PTC） by comparing CT signs of PTC with different sizes. Methods CT signs of 406 PTC from 396 patients confirmed by histology were analyzed retrospectively. Based on the largest tumor diameter, PTC were divided into 1.1-2.0 cm group, 2.1-3.0 cm group and〉3.0 cm group. Distribution of irregular shape, cookie bite sign, enhanced narrow/ fuzzy and microcalcification in each group was analyzed. Results There were 318 pieces in 1.1-2.0 cm group, 60 pieces in 2.1-3.0 cm group and 28 pieces in 〉3.0 cm group,respectively. The rate of irregular shape was 89.6% （285/318 ）, 75.0% （45/60） and 64.3% （ 18/28 ） in each group, the rate of cookie bite sign was 83.6% （266/ 318）, 71.7% （43/60） and 64.3%（18/28）, and enhanced narrow/fuzzy was 84% （267/318）, 78.3% （47/60） and 67.9% （19/28） in each group, and microcalcification was 35.5% （ 113/318 ）, 40.0% （24/60） and 59.3% （ 16/27 ） in each group. The rate of irregular shape （χ2=20.092, P=-0.000）and cookie bite sign 0（2=9.695, P=0.008 ）had statistical difference among the three groups, while the rate of enhanced narrow/fuzzy（χ2=5.175, P=0.075）and microcalcification （χ2=5.277, P=0.071） had no statistical difference among each group. Furthermore, irregular shape and cookie bite sign were compared between groups. Rate of irregular shape in 1.1-2.0 cm group and 2.1-3.0 cm （χ2= 9.746, P=0.002）group, 1.1-2.0 cm group and 〉 3.0 cm group （χ2=15.180, P=0.000） was statistically different.Rate of cookie bite sign in 1.1-2.0 cm group and 〉3.0 cm（χ2=6.560,P=-0.010）was statistically different. There was no statistical difference between other groups. Conclusions Although irregular shape, cookie bite sign, enhanced narrow/fuzzy and microcalcification are important CT signs in diagnosing PTC, distribution of different signs varies with tumor sizes. Correct identification of these differences will help to improve the accuracy
作者
王海滨
舒艳艳
韩志江
丁金旺
Wang Haibin;Shu Yanyan;Han Zhijiang;Ding Jinwang(Department of Radiology, Hangzhou First People＇s Hospital, Hangzhou 310006, China （Wang HB, Han ZJ, Ding JW;Deportment of Radiology, Xiaoshan District First People＇s Hospital of Hangzhou, Hangzhou 311200, China （Shu YY)
出处
《中华内分泌外科杂志》
CAS
2018年第2期132-135,139,共5页
Chinese Journal of Endocrine Surgery
