多层螺旋CT诊断结节性甲状腺肿合并甲状腺癌  

Value of MSCT in diagnosis of nodular goiter with coexistent thyroid carcinoma

作　　者：陈广银 陈悦熙[1] CHEN Guangyin, CHEN Yuexi(Department of Radiology, the Twelfth People＇s Hospital of Guangzhou, Guangzhou 510620, Chin)

机构地区：[1]广州市第十二人民医院放射科,广东广州510620

出　　处：《分子影像学杂志》2018年第2期175-177,共3页Journal of Molecular Imaging

摘　　要：目的探讨多层螺旋CT对结节性甲状腺肿合并甲状腺癌的诊断价值。方法回顾性分析25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,比较患者肿瘤数目、边界、形态、大小、密度等方面的情况。结果 22例结节性甲状腺肿和甲状腺癌独立存在,3例为甲状腺癌病灶,位于结节性甲状腺肿内;其中,共发现结节性甲状腺肿病灶40个,甲状腺癌病灶28个。20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,边界不清楚,称为"边界反转征";23例癌灶位于甲状腺边缘且18例突破包膜,出现"边缘中断征";癌灶内钙化15例;颈部淋巴结转移13例。结论结节性甲状腺肿合并甲状腺癌的多层螺旋CT征象具有一定特征性,利用多层螺旋CT多平面重建技术全面观察每个结节,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 the diagnostic value of multi-slice spiral CT（MSCT） in nodular goiter with coexistent thyroid carcinoma. Methods CT findings of 25 patients with pathologically-diagnosed nodular goiter associated with thyroid carcinoma were retrospectively analyzed. Results In 3 cases the cancerous lesion was located within the nodular goiter, and in the other 22 cases the nodular goiter and the cancerous lesion existed independently. CT plain scan of 20 cases were obvious low density with a relatively well demarcated margin, and contrast-enhanced CT scanning showed homogeneous or heterogeneous enhancement with poorly defined margin of the lesion, known as ＂boundary reversion＂ sign. In 23 cases, the margin of lesion was irregular, and the tumor broke through the capsule, forming the so-called ＂remnant margin＂ sign.Calcification within the cancerous lesion was observed in 15 cases, and cervical lymph node metastasis in the ipsilateral neck root or clavicular region was detected in 13 cases. Conclusion The MSCT features of nodular goiter with coexistent thyroid cancer have certain characteristics, using which the comprehensive observation of each nodule can effectively reduce the misdiagnosis of thyroid carcinoma associated with nodular goiter.

关 键 词：结节性甲状腺肿 甲状腺癌 体层摄影术 X线计算机 

分 类 号：R581[医药卫生—内分泌] R730.44[医药卫生—内科学] R736.1[医药卫生—临床医学]