甲状腺未分化癌的影像学特点分析  

Imaging features of anaplastic thyroid carcinoma

作　　者：梁可可 王怀涛[1] 张小薄[1] 周磊[1] 许维雪[1] 谭晓冬[1] Liang Keke;Wang Huaitao;Zhang Xiaobo;Zhou Lei;Xu Weixue;Tan Xiaodong(Department of Panereatical and Thyroidal Surgery,Shengjing Hospital of China Medical University,Liaoning Shenyang 110001,China.)

机构地区：[1]中国医科大学附属盛京医院胰腺甲状腺外科,辽宁沈阳110001

出　　处：《现代肿瘤医学》2018年第19期3119-3122,共4页Journal of Modern Oncology

摘　　要：目的:探讨甲状腺未分化癌的超声及CT特点。方法:选取2009年1月至2016年12月于我院行手术治疗且经术后病理证实的14例甲状腺未分化癌患者,回顾性分析其超声及CT特点。结果:女性患者多于男性(57.1%vs 42.9%);患者年龄较大,平均(69.4±11.4)岁;肿物多为单发,直径较大,平均(5.7±2.2)cm。12例患者术前于我院行超声检查,8例患者术前行CT检查(7例行平扫+增强扫描、1例仅行平扫扫描)。肿物多表现为形态不规则、边界模糊、实性,可伴粗大钙化、坏死,且多伴有周围侵犯。超声下肿物回声多不均匀,呈中低混合回声或低回声,纵横比多小于1,且血流丰富。肿物实性部分平扫CT值平均(48.5±10.0)HU;动脉期轻中度强化,CT值平均(70.7±17.5)HU;静脉期进一步强化,CT值平均(87.1±15.3)HU;且均为不均匀强化。结论:甲状腺未分化癌多见于老年女性,多为单发实性、体积较大、形态不整、边界不清、伴周围侵犯,可伴粗大钙化、坏死;超声下呈不均匀低回声或中低回声、血流丰富、纵横比小于1;CT增强扫描呈不均匀强化,动脉期轻中度强化,静脉期进一步强化。Objective：To investigate the ultrasound and CT features of anaplastic thyroid carcinoma（ATC）. Methods ： 14 cases of ATC diagnosed between January 2009 and December 2016 were enrolled in the study. We retrospectively reviewed the ultrasound and CT features of the 14 ATC cases. Results：There were 8 female and 6 male, and their mean age at diagnosis was （69.4 ± 11.4） years. Most of the tumors were single and had a large size,with a mean diameter of （5.7 ±2.2）cm. Among the 14 cases, 12 cases had preoperative ultrasound and 8 cases had preoperative CT examination（7 cases with enhanced scans）. ATC appeared as irregular-shaped, ill-defined, solid masses accompanied by necrosis ,macrocalcification and direct invasion into the adjacent tissues. The common ultrasound features of ATC were uneven hypoechoic or iso - hypoechoic, rich blood flow and anteroposterior - to - transverse ratio less than 1. All cases in CT enchanced scans showed heterogenous enhancement. The mean CT value of solid portion was （48.5 ± 10.0） HU in plain scan, （70.7± 17.5） in ultrasound, and presented heterogenous enhancement in CT enhanced scans （mild -to -moderate enhance- ment in arterial phase and further enhaHU in arterial phase and （ 87.1 ± 15.3 ） HU in venous phase, respectively. Conclusion ：ATC was more common in old women. Most of the tumors appeared as single, solid, large size, irregular - shaped, ill - defined, accompanied -to-tuansverse ratio less than 1 in ultrasound ,and presented heterogenous enhancement in Ct enhanced scans（mild-to-moderate enhancement in arterial phase and further enhancement in venous phase）.

关 键 词：甲状腺未分化癌 超声 计算机体层成像 诊断 

分 类 号：R736.1[医药卫生—肿瘤]