甲状腺结节良恶性与MRI表现特征的相关性研究  

Correlation between MRI Findings and Pathological Type in Thyroid Nodules

作　　者：刘洁[1] 徐海波[1] 王耀宗[2] 孔祥泉[1] 刘定西[1] 郭慧慧[1] 王晶[1] 代孟[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022 [2]华中科技大学同济医学院附属协和医院两腺外科,武汉430022

出　　处：《临床放射学杂志》2013年第6期788-792,共5页Journal of Clinical Radiology

摘　　要：目的研究甲状腺结节MRI的特征表现及其与病理类型的相关性。方法回顾性分析72例甲状腺结节患者术前的MRI表现特征与术后病理结果的关系,并行统计学检验。结果 72例共计有结节192个,包括147个良性结节和45个恶性结节。良恶性结节的MRI表现在数目、形态(χ2=95.02)、"包膜"(χ2=73.51)、囊变(χ2=67.96)、实性部分强化特点(χ2=77.41)及淋巴结肿大方面差异具有显著统计学意义(P<0.05),而在有无出血和/或钙化方面差异无统计学意义(χ2=0.028,P=0.867)。结论结节MRI表现为单发、形态不规则、囊变少及实性部分强化不均可提示恶性诊断;无明确边界或瘤周有"包膜"样低信号影但不连续是恶性结节的特征性表现;甲状腺周围脂肪间隙是否清晰,邻近组织器官是否受侵,是否有颈部淋巴结转移和/或远处转移是鉴别良恶性结节的主要征象。Objective To investigate the correlation between MRI findings and pathological type in thyroid nodules. Methods Preoperative MRI findings and Postoperative pathological type of 72 patients with thyroid nodules were analyzed retrospectively. Results 72 patients had a total of 192 nodules, included 147 benign and 45 malignant lesions. The MRI findings had significant difference between benign and malignant thyroid nodules in number, shape（ X^2 = 95.02） , ＂enve-lope＂ （ X^2 = 73.51 ）, cystic change（ X^2 = 67.96）, enhancement characteristics of solid part（X^2 = 77.41 ）, and lymph node enlargement （ P 〈 0.05 ）. But the differences hsd no significant difference in bleeding and/or calcification （ X^2 = 0. 028, P = 0. 867）between benign and malignant lesions. Conclusion On MRI, solitary tumor, irregular shape, lack of cystic change and heterogeneous enhancement of solid part were important features ; obscure margin or the peri tumoral discontinu-ous ＂ envelope-like＂ sign with low signal intensity were characteristic findings of malignant lesions; infiltration of thyroid surrounding organ tissue, cervical lymph node metastases or distant metastasis were confirmative findings for the diagnosis of malignant nodules on MRI.

关 键 词：甲状腺结节 磁共振成像 结节性甲状腺肿 甲状腺癌 甲状腺腺瘤 

分 类 号：R736.1[医药卫生—肿瘤]