甲状腺癌的MRI诊断  

Diagnosis of Thyroid Carcinoma by Ma gnetic Resonance Imaging(MRI )

作　　者：关玉宝[1] 谢榜昆[1] 袁小平[1] 李海刚[2] 

机构地区：[1]中山大学附属第二医院放射科 [2]中山大学附属第二医院病理科,广东广州510120

出　　处：《癌症》2003年第7期739-744,共6页Chinese Journal of Cancer

摘　　要：背景与目的:MRI现已成为诊断甲状腺病变的重要手段,国外有关甲状腺癌的MRI研究已有较多报道,而国内报道甚少。本研究旨在通过分析甲状腺癌的MRI表现及组织病理学特点,探讨MRI在甲状腺癌诊断中的价值。方法:回顾性分析31例甲状腺癌患者的术前MRI表现,并与术后病理检查结果对比。结果:31例甲状腺癌患者中20例MRI信号不均匀,病理学显示肿瘤出现不同程度坏死、出血或囊变;22例肿瘤形态不规则、呈分叶状;22例肿瘤边缘模糊,其中10例可见瘤周不完整包膜样低信号影,病理检查发现肿瘤已侵犯并突破假包膜;19例肿瘤侵犯周围组织器官,19例出现颈部淋巴结转移。结论:瘤周不完整包膜样低信号影是甲状腺癌的MRI特征性表现;肿瘤边缘模糊、形状不规则及信号不均匀是诊断甲状腺癌的重要指征;MRI能够较好的显示小病灶、病灶形态改变及肿瘤侵犯的范围。BACKGROUND &OBJECTIVE:Mag netic resonance imag ing(MRI )has been demonstrated to be important for the evaluation of thyroid diseases.Several foreig n authors h ave reported MRI manifestation of th yroid carcinoma;however,there were few r eports about this in China.This stud y was desig ned to investig ate the diag nos tic value of MRI in thyroid carcinoma by comparing MRI manifestation with hi stopatholog ical features of thyroi d carcinoma.METHODS :Thirty-one cases of thyroid carcino ma were analyzed retrospectively with preoperation al MRI and postoperational patholog ical finding s.RESULTS :Among 31cases of thyroid carcinoma,20cases showed heterog eneous intensity in MRI and l iquefied or hemorrhag ic or cystic deg eneration at histopatholog ical examination.Twenty-two cases show ed ill defined.Twenty-two cases showed ir reg ular shapes ,of 10cases showed'the discontinuous capsule-like sig n wi th low sig nal intensity around the tu mor 'in MRI and that pseudocapsules have been pe netrated and partially destroyed by tumors in histopatholog ical findin g s.Nineteen cases showed the tumors infiltrated the adjacent structures.Nineteen c ases showed metastatic lymphadenop athy on the neck.CONCLUSION:'The discontinuous capsule-like sig n with low sig nal intensity around the tumor 'is the characteristic manifestatio n of thyroid carcinoma on MRI.Heterog eneous sig nal,obscure marg in,and irreg ular s hape are the important features for diag nosis of thyroid carcinoma.MRI can demonstrate small lesions ,provide the precise morpholog ic characteristics of lesions,and accurately define the l ocal extension of tumors.

关 键 词：甲状腺癌 MRI 诊断 病理学 

分 类 号：R736.1[医药卫生—肿瘤]