CT三维成像对甲状腺外科手术指导及随访预后评估的价值研究

目的研究CT三维成像对甲状腺外科手术指导及随访预后评估的价值。方法回顾性分析2018年10月至2019年10月我院收治的经手术病理证实的300例甲状腺疾病患者的临床资料,均行CT三维成像检查。结果180例结节性甲状腺肿中单发结节10例,双侧多发结节170例,多发结节表现为双侧甲状腺弥漫性肿大,可见大小不等的低密度灶,增强扫描后强化;单发病灶表现为边界清楚的甲状腺内低密度灶。13例甲状腺腺瘤均为单发,CT平扫呈边界清晰的类圆形低密度肿块影,增强后病灶强化,囊变周围环形强化。7例亚急性甲状腺炎患者表现为双侧甲状腺弥漫性增大,密度减低,增强扫描后强化,且边缘完整清晰;100例恶性肿瘤病灶平扫表现为边界不清的均匀密度肿块,增强后强化,病灶内见不规则钙化,且部分病灶伴有淋巴结转移,内部囊变无强化;CT对静脉受侵和颈动脉受侵检出率为89.58%和100.0%,均高于CT(62.50%和53.85%,P<0.05);甲状腺良性病变中淋巴结转移例69例,经手术病理证实均为反应性增大;恶性病变中,淋巴结转移例52例,手术共检出淋巴结转移104枚,其中平扫检出率为88.10%,增强扫描检出转移淋巴结检出率为95.16%。结论CT三维成像可反映甲状腺病变形态、大小、密度及与周围组织结构的关系和颈部淋巴结情况,对良恶性鉴别和评估预后具有重要的价值。

The Value of CT Three-dimensional Imaging in Thyroid Surgery Guidance and Follow-up Prognosis Evaluation

Obijctive To study the value of CT three-dimensional imaging in thyroid surgery guidance and followup prognosis evaluation.Methods The clinical data of 300 patients with thyroid disease confirmed by surgery and pathology admitted to our hospital from October 2018 to October 2019 were retrospectively analyzed.All patients underwent CT three-dimensional imaging.Results Among the 180 cases of nodular goiter,10 cases had single nodules,and 170 cases had multiple nodules on both sides.The multiple nodules presented as bilateral diffuse enla rgement of the thyroid gland,with low-density lesions of different sizes,which were enhanced after enhanced scanning.The single lesion presented as a well-defined low-density lesion in the thyroid gland.All the 13 cases of thyroid adenomas were single,and the plain CT scan showed a clear boundary of a round,low-density mass shadow.After enhancement,the lesion was strengthened,and the cystosis was surrounded by ring enhancement.7 patients with subacute thyroiditis showed bilateral diffuse enla rgement of the thyroid gland,decreased density,enhancement after enhanced scanning,and complete and clear margins.In 100 cases of malignant tumors,the plain scan showed homogeneous masses with unclear boundaries,which were enhanced after enhancement.Irregular calcification was found in the lesions,and some of the lesions were accompanied by lymph node metastasis,without enhancement of internal cystic change.The detection rates of vein invasion and ca rotid artery invasion were 89.58%and 100.0%respectively,both higher than 62.50%and 53.85%,respectively(P<0.05).There were 69 cases of lymph node metastasis in benign thyroid lesions,all of which were proved to be reactive enlargement by operation and pathology.Among the malignant lesions,there were 52 cases of lymph node metastasis,and 104 cases of lymph node metastasis were detected by the surgery,among which the detection rate was 88.10%by plain sca n and 95.16%by enhanced scan.Conclusion CT three-dimensional imaging can reflect the shape,size,density of thyroid lesions,the relationship with the surrounding tissue structure,and the situation of cervical lymph nodes.