甲状腺病变累及至上纵隔的MDCT表现特征及其解剖、病理学基础  

MDCT Features and Anatomic-pathological Basis of Thyroid Diseases Involving the Upper Mediastinum

作　　者：叶奕兰[1,2] 杨志刚[2] 邵恒[2] 陈静[2] 唐思诗[2] 文凌仪[2] 

机构地区：[1]解放军第四五二医院医学影像科,成都610021 [2]四川大学华西医学院放射科,成都610041

出　　处：《生物医学工程学杂志》2013年第1期71-75,共5页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(30970820)

摘　　要：为了明确甲状腺病变累及至上纵隔的多层螺旋CT(MDCT)影像表现特点及其解剖、病理学基础,回顾性收集经临床病理证实的累及至上纵隔的甲状腺病变49例(其中结节性甲状腺肿22例,甲状腺瘤13例,甲状腺癌14例),结合其解剖、病理学基础,分析其MDCT表现特征及优势解剖分布。结果发现甲状病变向下位于前上纵隔约占67.3%(33/49)、后上纵隔14.3%(7/49)、跨前后纵隔18.4%(9/49);不同性质病变有各自特征性的MDCT表现:结节性甲状腺肿以局限多发结节、肿块为主,约占77.3%(17/22);甲状腺腺瘤以单发肿块为主,约占92.3%(12/13);甲状腺癌以单发肿块为主,约占57.1%(8/14),9例合并有颈部和(或)纵隔淋巴结转移。因此,甲状腺病变累及至上纵隔,位于前上纵隔多见,后纵隔少见,其影像学表现及优势解剖分布与其解剖、病理基础密切相关。To determine the multidetector computed tomography （MDCT） features as well as the anatomic-pathologi- cal basis in thyroid diseases involving the upper mediastinum, we performed a retrospective analysis of 49 patients who had thyroid diseases involving the upper mediastinum. In the study, 22 cases were nodular goiter, 13 cases were thyroid adenoma, and 14 cases were thyroid cancer. The relevance between MDCT appearances and their diffusing route of common thyroid diseases as well as the anatomic-pathological features in this region were evaluated. It was found that the lesions located in the upper anterior mediastinum, the upper posterior mediastinum, and both sides were 67.3% （33/49）, 14. 3% （7/49）, 18.4%（9/49）, respectively. Different diseases had their distinct MDCT fea- tures： nodular goiter mainly showed localized and multiple nodules or tumor bulk （77.3 %）, thyroid adenoma mainly showed solitary tumor bulk （92.3%）, and thyroid cancer mainly demonstrated solitary tumor bulk （57. 1%）, re- spectively. Among the 49 cases, 9 cases had cervical and/or mediastinal metastases in lymph nodes. The thyroid dis- eases involving the upper mediastinum most commonly occurred in the upper anterior mediastinum. The MDCT fea- tures and distribution of diffusing thyroid lesions in cervico-thoracic junctional region closely correlated with the ana- tomic-pathological characteristics in this region.

关 键 词：甲状腺 上纵隔 颈部 解剖学 病理学 

分 类 号：R816.6[医药卫生—放射医学]