螺旋CT与高频超声诊断甲状腺癌价值的对比研究

目的: 分析甲状腺癌的螺旋CT (spiral CT, SCT)与高频超声(high-frequency ultrasound, US)表现,评价两者对甲状腺癌的诊断价值.材料和方法: 回顾性分析49例同期螺旋CT与高频US检查的甲状腺癌的表现,主要对原发病灶和颈部转移淋巴结进行对比分析,并与手术及病理结果对照.结果: 49例甲状腺癌,共58个原发病灶,螺旋CT与高频US均显示肿瘤病灶,形状不规则、密度/回声不均匀和边缘不清楚,两者无显著性差异(P>0.05). 螺旋CT显示16个瘤周"半岛状"瘤结节,11个瘤周"残圈"征.螺旋CT检出13个病灶微钙化,高频US检出22个病灶微钙化,两者无显著性差异(P>0.05).对颈部转移淋巴结,螺旋CT显示率84%(31/37),高频US显示率86%(32/37).结论: 高频超声应作为甲状腺癌的首选和重要检查方法,螺旋CT在评价甲状腺癌的原发灶、颈部转移淋巴结方面有一定特征性,两者结合起来,可提高甲状腺癌术前评估和诊断的准确性.

Comparative Study of Spiral CT and Ultrasound in Diagnosis of Thyroid Carcinoma

Purpose: To study the spiral CT(SCT) and high-frequence ultrasound(US) appearances of preoperative thyroid carcinoma, evaluate the diagnostic value of the two modalities. Materials and Methods: Forty nine patients with thyroid carcinoma underwent both SCT and high-frequence US examination. The images were reviewed of primary lesion and metastatic lympadenopathy in the neck, compared with operation and pathology. Results: Of 49 patients with 58 lesions, there was no significantly difference in showing the primary lesion, irregular shape, heterogeneous density/echo and unclear margin between high-frequence US and SCT(P>0.05). "Peninsluar tubercles around the tumor" was revealed in 16 primary tumors, and "no complete ring around the tumor" was revealed in 11 primary tumors on SCT. Thireen lesions with microcalcifications were detected on CT, and 22 lesions were detected by high-frequence US. There was not significantly difference between SCT and US(P>0.05). CDFI showed rich blood signal in 67%(39/58). In detecting metastatic lympadenopathy in the neck, SCT correctly identified 31 of 37(84%) and high-frequence US 32 of 37 (86%). Conclusion: High-frequence US should be used as the first choice of examination for thyroid carcinoma. SCT has some characteistics to evaluate the primary lesion and cervical lymphadenopathy. The diagnosis of thyroid carcinoma, when associated SCT with high-frequence US, should be more accurate.