发性甲状腺淋巴瘤CT与MRI表现  

CT and MRI findings of primary thyroid lymphoma

作　　者：王宏琢 覃春红 冷西 WANG Hongzhuo;QIN Chunhong;LENG Xi(Department of Radiology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一附属医院影像科,广东广州510405

出　　处：《实用放射学杂志》2019年第9期1399-1401,1410,共4页Journal of Practical Radiology

摘　　要：目的探讨原发性甲状腺淋巴瘤(PTL)的CT及MRI特征性表现,提高诊断准确率。方法回顾分析经病理证实的13例PTL患者的影像资料。结果 13例PTL中累及整个甲状腺组织8例,4例累及甲状腺单侧叶及峡部,1例仅累及甲状腺单侧叶。病灶CT平扫密度均明显低于正常甲状腺,MRI上T1WI呈等或略高信号,T2WI呈稍高信号,DWI呈高信号。13例病灶1例边界较清楚,其余边界均模糊不清。增强后其中2例CT病灶呈不均匀轻度强化,其余病灶均呈轻度均匀强化;9例(9/13)于病灶中或病灶边缘见条片或细条状明显强化影,提示残留的甲状腺组织。结论大部分PTL呈弥漫性生长、密度或信号较均匀,边界不清;在低强化病灶中或病灶边缘见到条片或细条状明显强化影是其特征性的表现。结合肿瘤的生长方式及临床病史,术前可作出较为准确的诊断。Objective To improve diagnostic accuracy of primary thyroid lymphoma (PTL) by investigating its CT and MRI characteristics. Methods CT and MRI images of 13 patients with pathology confirmed PTL were analyzed retrospectively. Results PTL mass invaded into whole thyroid gland in 8 cases, unilateral thyroid lobe and isthmus in 4 cases, and unilateral thyroid lobe in 1 case. Non-enhanced CT images showed the mass with significantly lower dens让y than normal thyroid gland. On MRI, it showed isointensity or slightly hyperintense signal on T] WI, slightly hyperintense signal on T2 WI, and hyperintense signal on DWI. Most PTL mass had an unclear boundary except for one that invaded unilateral thyroid lobe. After injection of contrast agent, most mass showed slight homogeneous enhancement, but two masses showed slight inhomogeneous enhancement. Nine cases ( 9/13 ) showed patchy or thin strip-like enhancements in the mass or at the marginal area, prompting residual thyroid gland.Conclusion Most PTL masses show diffuse infiltration in the thyroid gland, with an unclear boundary and homogeneous density or signal. The specific characteristics of PTL is the patchy or thin striplike significant enhancements in the slight enhancement mass or at the marginal area. Combining with the growth pattern and clinical history of the mass, a more accurate diagnosis can be made before surgery.

关 键 词：原发性甲状腺淋巴瘤 磁共振成像 计算机体层成像 

分 类 号：R736.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]