甲状腺结节CT征象与病理对照分析

目的探讨螺旋CT检查对良恶性甲状腺结节鉴别诊断价值。方法对湖北医药学院附属人民医院90例甲状腺结节(甲状腺腺瘤、结节性甲状腺肿、甲状腺癌)病例采用常规CT平扫及动态增强扫描,由2名高年资医师对病例的CT征象进行评价并给出CT诊断,并与病理学检查进行比较。结果 CT诊断良性结节79例,甲状腺癌11例,病理学检查示良性结节83例、甲状腺癌7例。CT诊断良性结节准确率为95.18%(79/83),良性结节有诊断意义的CT征象为边缘清楚、周围脂肪间隙清晰及无淋巴结转移,占93.98%(78/83),恶性组仅1例出现14.29%(1/7)],甲状腺癌主要CT征象有病灶形态不规则、边界不清,密度混杂不均,多伴有淋巴结或其他器官转移71.43%(5/7)]。结论 CT对甲状腺良恶性结节的鉴别具有重要价值,掌握甲状腺良恶性结节的主要CT征象有助于良恶性的鉴别。

The Thyroid Nodules: Correlation of CT Findings and Pathology

Objective To explore the value of spiral CT in differential diagnosis of benign and malignant thyroid nodule.Methods 90 thyroid nodules(thyroid adenoma,nodular goiter,thyroid carcinoma)selected from People′s Hospital Affiliated to Hubei University of Medicine adopted conventional plain CT scan and dynamic enhanced scan before the operation.And two experienced senior doctors were responsible to evaluate and diagnose each CT symptom.Results CT diagnosis suggested 79 benign thyroid nodules and 11 thyroid carcinomas;pathological examination results showed 83 benign thyroid nodules and 7 thyroid carcinomas.CT diagnosis accuracy of benign nodule was 95.18%(79/83).The CT features of diagnostic significance in benign nodules:clear margin,peripheral fat space was clear and without lymph node metastasis 93.98%(78/83),only one case can be found in the malignant group 14.29%(1/7).Irregular tumor outline,heterogeneous enhancement,invading neighbor structures and lymph node metastasis could only be found in thyroid malignant tumors 71.43%(5/7).Conclusion CT has a notable advantage in differential diagnosis between benign and malignant thyroid nodules.Mastering the CT features of various thyroid nodules can improve the accuracy of differential diagnosis.