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CT鉴别诊断甲状腺单发结节良恶性的作用研究

  

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-03-25

Study of CT’s Value in Solitary Thyroid Nodulous Disease’s Differential Diagnosis

  • Received:1900-01-01 Revised:1900-01-01 Online:2012-03-25

摘要: 目的:探讨CT在甲状腺单发结节良恶性鉴别诊断中的作用。方法:回顾分析2000年1月-2011年6月经病理组织学检查确诊的100个甲状腺单发结节CT表现,比较良恶性甲状腺单发结节CT表现及征象的差异。结果:良性甲状腺单发结节呈圆形或类圆形,多为多发低密度结节,外形规则,直径0.8-5.1cm不等。平扫可见蛋壳状和(或)斑块状粗钙化,强化后边界变清晰,42例致甲状腺增大、变形,25例压迫气管周围结构,所有病灶均无外侵征象,颈部同侧淋巴结肿大2例。恶性甲状腺单发结节分叶状或形状不规则,密度多不均匀,以低密度为主,直径0.6-5.6cm不等,可见结节内出现细砂粒状、粗细钙化或混合性钙化,病变边缘多不规则,与周围组织分界不清;增强扫描后多呈不均匀强化,可有强化残圈征。15例侵犯周围组织气管,其中侵及气管6例,10例发现颈部淋巴结转移。良恶性甲状腺单发结节在结节直径、平扫密度及增强扫描动静脉期密度的无明显差异(P>0.05)。恶性甲状腺单发结节在形态不规则、囊实性形状、密度不均匀、边界不清晰、无包膜、钙化和远处转移比例显著高于良性甲状腺单发结节,差异具有统计学意义(P<0.05)。结论:结节CT影像学的密度、形态、边界、包膜、钙化和是否远处转移对甲状腺单发结节良恶性鉴别诊断具有重要意义。

Abstract: Objective:To study CT’s value in solitary thyroid nodulous disease’s differential diagnosis.Methods:The CT signs of 100 solitary thyroid nodules between Jan 2000 and Jun 2006 were retrospectively analyzed.The differences between benign and malignant solitary thyroid nodules were compared.Results:The benign solitary thyroid nodules were round or round-like with low density,the shape was regular and the diameter ranged from 0.8cm to 5.1cm.The calculus in plain CT were shell-like or plaque.The malignant solitary thyroid nodules were lobulated with irregular shape and the density wasn’t uniform.The diameter ranged from 0.6cm to 5.6cm.The malignant solitary thyroid nodules were higher than benign solitary thyroid nodules in irregular shape,nodule density,contour,capsule,calculus and metastasis with statistics significances(P<0.05).Conclusion:Density,shape contour,capsule,calculus and metastasis of nodules’ CT sign were significantly important in solitary thyroid nodulous disease’s differential diagnosis.