甲状腺病变多层螺旋CT双期扫描初步研究  

The Study of Two Phase Scan with Multi-slice Helical CT in Thyroid Lesions

作　　者：李琳[1] 罗德红[1] 林蒙[1] 余小多[1] 王勇[1] 周纯武[1] 

机构地区：[1]中国医学科学院,中国协和医科大学肿瘤医院影像诊断科,北京100021

出　　处：《当代医学》2009年第20期94-100,共7页Contemporary Medicine

基　　金：高等学校博士学科点专项科研基金资助;基金项目批准号20040023041

摘　　要：目的评价甲状腺病变多层螺旋CT双期扫描影像特点及其临床应用价值。方法扫描甲状腺病变初诊患者45例,男16例,女29例,年龄8岁～78岁。所有病例经手术病理证实。全部病例均直接增强扫描,双期管电流分别为60mA,120mA,延迟25s及65s。分析病变在增强扫描双期CT值及其变化,将其强化方式分为五种类型。应用SPSS14.0对资料进行统计学处理。结果4组甲状腺病变在动脉期强化程度存在差异(P<0.05),静脉期强化程度无明显差异(P>0.05)。13例结节性甲状腺肿中表现为高/低密度区静脉期较动脉期强化程度增高(Ⅰ型)者最多,共6例(46.2%);高密度区强化程度降低,低密度区强化程度增高(Ⅳ型)者5例(38.5%)。甲状腺腺瘤9例(100%)表现为高/低密度区静脉期强化程度较动脉期减低(Ⅱ型)。甲状腺炎3例(100%)表现为Ⅰ型强化。甲状腺恶性肿瘤中表现为Ⅱ型者最多,共16例(80%)。甲状腺良性病变肿大淋巴结表现为形态规则、边界清楚、密度均匀、强化不明显且静脉期较动脉期进一步强化(Ⅰ型,5/5)。甲状腺恶性病变淋巴结形态多规则(9/12),边缘多清楚(10/12),密度多不均匀(8/12),强化明显,静脉期强化程度降低(Ⅱ型,11/12)者居多。结论甲状腺腺瘤和甲状腺恶性肿瘤多表现为Ⅱ型强化,结节性甲状腺肿多表现为Ⅰ型和Ⅳ型强化,甲状腺炎多表现为Ⅰ型强化。Objective To evaluate two phase helical computed tomography （CT） in the characterization of thyroid lesions. Methods Forty-five patients with thyroid lesions （16 male, 29 famale; age range 8-78 years）, underwent two phase helical CT. Images were obtained in arterial and venous phases with delays of 25 seconds and 65 seconds, respectively after the injection of contrast material at 60mA and 120mA. The histopathologic diagnosis was obtained by means of surgical resection in all patients. The attenuation change and enhancement patterns in the tumors were devided into five types（Ⅰ-Ⅴ）.The results were analyzed with SPSS 14.0 software. Results There were 13 modular goiter, 9 thyroid adenoma, 3 thyroiditis and 20 thyroid malignant tumor. The enhancement amplification of the thyroid lesions were statistically different in arterial pbase（P 〈0.05）, but not in venous phase（P〉0.05）. For 13 cases with nodular goiter, the attenuation in high and low density areas showed increase at venous phase compared to that at arterial phase in 6 cases（type Ⅰ, 6/13）, attenuation in high density areas decrease while low density areas increase in 5 cases （type Ⅳ,5/13）. All of thyroid adenoma showed decrease of attenuation in high and low density areas at venous phase compared to that at arterial phase（type Ⅱ,9/9）. All of thyroiditis showed increase of attenuation in high and low density areas（type,3/3）. Of the 20 cases of thyroid malignant tumor, 16 cases manifested decrease of attenuation in high and low density areas（type Ⅱ,16/20）. The lymph nodes resulted from thyroid benign lesions showed regular, delineated and homogeneous nodes with increase of attenuation at venous phase（type Ⅱ, 5/5）. The lymph nodes of thyroid malignant lesions showed regular shape（9/ 12）, clear margin（10/12）, heterogeneous density（8/12） and decrease of attenuation at venous phase（type Ⅱ, 11/12）. Conclusion Most of thyroid adenomas and malignant tumors manifestd type Ⅱ enhancement. The

关 键 词：多层螺旋CT 甲状腺 双期扫描 

分 类 号：R581[医药卫生—内分泌] R816.6[医药卫生—内科学]