多层螺旋CT在甲状腺癌和甲状腺腺瘤鉴别诊断中的价值  

Differential diagnosis of thyroid adenoma and adenocarcinoma:Advantage of multi-slice CT imaging

作　　者：佟桂玲[1] 赵宝英[1] 王宇[1] 耿昶[1] 

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《现代肿瘤医学》2017年第11期1790-1795,共6页Journal of Modern Oncology

基　　金：辽宁省直医院改革重点临床科室诊疗能力建设项目(编号:LNCCC-D43-2015)

摘　　要：目的:回顾性分析甲状腺癌和甲状腺腺瘤的多层螺旋CT影像特征,多层螺旋CT在甲状腺癌和甲状腺腺瘤的鉴别诊断中的价值。方法:将77例经手术病理证实的患者纳入研究,其中甲状腺癌42例,甲状腺腺瘤35例,均进行CT增强扫描。分析下列CT征象:病灶数量、大小、形态、平扫和增强的边缘特征、钙化、平扫CT值和增强CT值增强幅度和颈部淋巴结情况;探讨上述CT征象对两者的鉴别诊断价值。结果:甲状腺癌表现为不规则形稍低密度肿块,半数病灶可见钙化,以砂砾状钙化为主;增强后不均匀强化,大多数病灶平扫和增强均边缘不清,可侵犯周围器官,发生颈部淋巴结肿大。甲状腺腺瘤表现为类圆形低密度肿块,密度均匀或不均匀,少部分可有钙化,以粗大钙化为主,增强后不均匀强化,平扫和增强均边缘清晰,少有淋巴结肿大。病变的形状、边缘、钙化形态和邻近区域有无淋巴结肿大对两者鉴别有重要意义。结论:多层螺旋CT对甲状腺癌和甲状腺腺瘤的鉴别诊断具有重要的价值。Objective To analyze the imaging features of thyroid carcinoma and adenoma, and explore the value of CT images in the differential diagnosis of both entities. Methods： To data of 77 patients with thyroid lesions were un-derwent enhanced CT,including 42 cases of thyroid carcinomas and 35 cases of thyroid adenomas. The CT features as-sessed included number, size, marginal morphology, calcification, CT number of non - enhanced imaging, CT number of enhancement amplitude of the lesions and lymph node of neck. Results ： Thyroid carcinoma showed an irregular mass with heterogeneous hypodensity on non - enhanced images, half of the lesions with calcification, mainly gravel - like calcification, markedly heterogeneous enhancement, most of the lesions with unclear margin on non - enhanced and enhanced images, invasion of surrounding organs and neck lymph node enlargement. The thyroid adenoma showed an oval mass with heterogeneous hypodensity on non - enhanced images, blucky and patchy calcification in a few le-sions, markedly heterogeneous enhancement,most of the lesions with clear margin on non - enhanced and enhanced images, no invasion of surrounding organs and neck lymph node enlargement. The morphology and margin of the neo-plasm ,calcification and lymphadenopathy were more significant for the differentiation of both entities. Conclusion ： En-hanced CT image was helpful for the differentiation of thyroid carcinoma and thyroid adenoma.

关 键 词：诊断 鉴别诊断 甲状腺腺瘤 甲状腺腺癌 计算机断层成像 

分 类 号：R736.1[医药卫生—肿瘤]