甲状腺乳头状癌淋巴结转移的CT特征及临床意义  

CT features of metastasis and clinical significance of lymph node of papillary thyroid carcinoma

作　　者：齐效君[1] 邹贤[2] 孙志强[2] 王心涛[1] 朱海贤[1] 

机构地区：[1]江苏省原子医学研究所附属江原医院放射科,无锡214063 [2]江苏省原子医学研究所附属江原医院外科,无锡214063

出　　处：《实用医学影像杂志》2014年第6期433-435,共3页Journal of Practical Medical Imaging

摘　　要：目的：探讨甲状腺乳头状癌淋巴结转移的CT特征性表现，提高甲状腺乳头状癌淋巴结转移的诊断正确率，为外科手术方案和手术范围选择提供可靠依据。方法回顾分析经手术病理证实的共334例甲状腺乳头状癌患者的CT影像资料，对其中141例发生颈部淋巴结转移的病例进行统计学分析。结果141例患者中包括仅有中央区（Ⅵ区）淋巴结转移79例，CT诊断符合为60例；中央区及侧颈区（Ⅱ～Ⅴ区）均转移者62例， CT诊断符合51例。结果采用χ2检验。102例淋巴结密度、强化程度与甲状腺癌相似，其中23例伴有囊变坏死，14例伴有颗粒状钙化灶，7例并发喉返神经侵犯或气管、血管侵犯。结论甲状腺癌转移淋巴结好发部位为中央区；但侧颈区亦同样常常有转移，应高度重视。转移淋巴结的CT扫描特征：淋巴结明显强化，强化程度与甲状腺乳头状癌保持一致，可发生囊性变或坏死，以及出现颗粒状钙化灶，CT检查对临床手术方案制定具有重要指导意义。Objective To investigate the CT features of thyroid papillary carcinoma lymph node metastasis, im-prove the correct diagnosis rate of thyroid papillary carcinoma with lymph node metastasis, and provide a reliable ba-sis for surgical operation scheme and operation range selection. Methods Retrospectively analyze the CT image data of 334 cases with thyroid papillary carcinoma patients confirmed by operation and pathology, among them 141 cases with lymph node metastasis were statistically analyzed. Results Of 141 patients , 79 cases showed the central area （area Ⅵ） lymph node metastasis , and 60 cases were consistent by CT diagnosis. Sixty-two cases showed central and lateral neck area （area Ⅱ-Ⅴ） of metastasis and 51 cases were consistent by CT diagnosis. The results were analysed by chi-square test. A total of 102 cases of lymph node density and the strengthening degree were similar to thyroid carcinoma, including 23 cases with cystic necrosis, 14 cases accompanied with granular calcification, 7 cases compli-cated by recurrent laryngeal nerve invasion, vascular invasion or trachea. Conclusion The primary site for lymph node metastasis of thyroid carcinoma is central region,and neck region also often is involved, which should pay atten-tion to. CT scanning characteristics of lymph node metastasis of lymph node were showed as follows：lymph node en-hanced obviously, and the enhancement extent was consistent with thyroid papillary carcinoma, it may transferred to cystic degeneration or necrosis, and granular calcification, CT examination has an important guiding significance for clinical operation plan.

关 键 词：甲状腺肿瘤 淋巴结 肿瘤转移 体层摄影术 X线计算机 

分 类 号：R736.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]