MSCT鉴别诊断慢性淋巴细胞性甲状腺炎合并良恶性结节  

MSCT differential diagnosis of benign and malignant nodules in patients of chronic lymphocytic thyroiditis

作　　者：朱才松[1] 杨军[1] 杨静[2] 徐明[2] 邵康为[1] 刘伟[1] 王加临[1] 袁立新[1] 肖正光[1] 闵庆华[1] 张毅[1] 

机构地区：[1]上海市长宁区中心医院影像科,上海200336 [2]上海市长宁区中心医院病理科,上海200336

出　　处：《中国医学影像技术》2013年第4期524-527,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的比较慢性淋巴细胞性甲状腺炎(CLT)合并良恶性结节的MSCT特征,探讨MSCT的诊断和鉴别诊断价值。方法回顾分析经手术病理证实的74例(79个结节)CLT合并结节的MSCT表现,包括结节的大小、实质部分所占百分比、钙化、边缘、包膜、结节的强化方式及程度,并进行统计学分析。结果有81.82%(18/22)的恶性结节为完全实性,16例(16/57,28.07%)囊性为主的结节全部为良性结节(P均<0.05)。恶性结节钙化多于良性,多为细颗粒钙化,位于病灶内部(P均<0.05)。恶性结节边缘多不清,无包膜或包膜不完整,多均匀强化(P均<0.05)。良恶性结节在结节与结节外甲状腺组织平扫、动脉期及实质期CT值之比差异无统计学意义(P均>0.05)。结论 MSCT有助于鉴别诊断CLT患者合并良恶性结节典型特征。Objective To compare MSCT features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis （CTL）, and to observe the value of MSCT in identification and diagnosis of these lesions. Methods MSCT findings, including the size, percentage of solid element, calcification, margin, capsule, the pattern and the degree of en- hancement of 79 thyroid nodules in 74 patients with CLT were retrospectively analyzed, the differences of benign and malig- nant nodules were compared statistically. Results About 81.82~ （18/22） malignant nodules were almost entirely solid, while 28.07~ （16/57） benign nodules were mainly to cystic （all P〈0.05）. Malignant nodules more frequently appeared microcalcification and internal calcification than those of benign nodules （all P〈0.05）. Malignant nodules were likely to be ilbdefined margin, lack capsule or insufficient capsule, homogeneous enhancement （all P〈0.05）. There was no significant differences between malignant and benign nodules in ratio of nodules and thyroid tissues outside nodules in plain, arterial phase, parenchymal phase （all P〉0.05）. Conclusion MSCT is helpful to differentiate benign and malignant nodules in CLT patients.

关 键 词：甲状腺炎 自身免疫性 甲状腺肿瘤 甲状腺结节 体层摄影术 X线计算机 

分 类 号：R518[医药卫生—内科学] R814.42[医药卫生—临床医学]