甲状腺乳头状癌及淋巴结转移的CT表现

目的:评价甲状腺乳头状癌及淋巴结转移的CT特点。方法:回顾性分析我院手术病理证实的53例甲状腺乳头状癌伴淋巴结转移的CT表现。结果:44例为单发病灶,9例呈多发病灶;25例单发病灶和9例多发病灶表现为边缘模糊;25例肿块内见有钙化,14例颗粒状钙化,5例乳头状钙化,6例不规则钙化。49例转移淋巴结边缘规则,另4例边缘模糊或呈融合趋势;转移淋巴结有明显钙化的25例(颗粒状钙化19例,乳头状钙化4例,不规则钙化2例);22例淋巴结有囊性变,13例囊壁内见有乳头状强化。结论:甲状腺体积增大,肿块呈浸润性生长,边界不清的伴有颗粒状钙化的,是诊断甲状腺乳头状癌的重要指征;若同时伴有颈部淋巴结囊性变、囊壁内乳头状结节及颗粒状钙化,是诊断甲状腺乳头状癌的最可靠征象。

CT appearances of papillary carcinoma of thyroid with lymph node metastasis

Objective:To evaluate CT features of papillary carcinoma of thyroid with lymph node metastasis (LN-M).Methods:CT findings of 53 cases of papillary carcinoma of thyroid with LN-M proved surgically and pathologically were retrospectively analyzed.Results:The mass was solitary in 44 cases,multiple foci in 9 cases; the margin was vague in 25 cases of solitary mass and 9 cases of multiple foci; calcification was found in the mass (n=25), of which the shape was granular (n=14), papillary (n=5) and irregular (n=6). The margin of metastatic LN was irregular (n=49) or vague and fused (n=4); LN with obvious calcification was found in 25 cases (granular-like in 19, papillary-like in 4 and irregular in 2); LN with cystic change was found in 22, intra-cystic wall papillary enhancement was found in 13 cases.Conclusion:It is the important sign to diagnose papillary carcinoma that the volume of the thyroid is enlarged with aggressive mass, vague margin, and granular calcification. It is the dependable sign to diagnose that the masses accompany cervical LN cystic change, intra-cystic wall papillary node, and granular calcification.