结节性甲状腺肿合并甲状腺癌的CT诊断  

CT Diagnosis of Nodular Goiter Complicated by Thyroid Cancer

作　　者：徐列印[1] 邱维加[1] 何敏丽[1] 廖秀兰[2] 

机构地区：[1]桂林医学院附属医院放射科,广西541001 [2]桂林医学院附属医院临桂院区神经外科

出　　处：《临床放射学杂志》2015年第1期28-31,共4页Journal of Clinical Radiology

摘　　要：目的探讨结节性甲状腺肿合并甲状腺癌的CT征象。方法回顾性分析20例手术病理确诊为结节性甲状腺肿合并甲状腺癌患者CT资料。结果 5例癌灶位于结节性甲状腺肿内,15例甲状腺癌与结节性甲状腺肿独立存在;19例CT平扫癌灶呈明显低密度,边界相对清楚,增强后癌灶均匀或不均匀明显强化,癌灶与正常甲状腺组织或结节性甲状腺肿密度差降低,边界不清楚,称为"边界反转征";17例癌灶边缘不规整且12例突破包膜,即所谓"残边征";癌灶内钙化7例;癌灶同侧颈根部或锁骨区淋巴结转移8例。结论结节性甲状腺肿合并甲状腺癌的CT征象与单纯性甲状腺癌CT表现相似,全面观察每个结节,重点观察CT平扫中为低密度结节的CT征象改变,如"边界反转征"和"残边征",能有效减少结节性甲状腺肿中合并甲状腺癌的漏诊。Objective To explore CT manifestations of nodular goiter with coexisting thyroid cancer. Methods CT features of 20 patients with Pathologically-proved nodular goiter associated with thyroid cancer were retrospectively ana- lyzed. Results The cancerous lesion was located within the nodular goiter in five cases, and in the other 15 cases the nodular goiter and the cancerous lesion were separately and independently existed. In 19 cases, plain CT scanning showed that the cancer displayed low-density shadow with a relatively clear border. On contrast-enhanced CT scanning the cancer showed homogeneous or heterogeneous enhancement, and the density difference between the cancer and normal thyroid tis- sue was decreased and the lesion＇ s margin became unclear, known as ＂boundary reversion＂ sign. In 17 cases, the margin of lesion was irregular, and the cancer broke through the capsule, forming the so-called ＂remnant margin＂ sign. Calcifica- tion within the cancerous lesion was observed in 7 cases. Lymph node metastasis at the ipsilateral neck root or clavicular re- gion was detected in 8 cases. Conclusion The CT manifestations of nodular goiter with coexisting thyroid cancer are simi- lar to those of pure thyroid cancer. Comprehensive observation of each nodule, focusing on low-density nodules on plain CT scans, ＂boundary reversion＂ sign, ＂remnant margin＂ sign, etc. can effectively reduce the misdiagnosis of thyroid carcino- ma associated with nodular goiter.

关 键 词：结节性甲状腺肿 甲状腺癌 计数机断层摄影 

分 类 号：R581.3[医药卫生—内分泌]