甲状腺肿瘤的MRI诊断分析

目的分析甲状腺癌的MRI表现、组织病理学特点,探讨MRI在甲状腺癌诊断中的价值。方法选取临床诊断或高度怀疑甲状腺癌的病例50例,术前行MRI检查并做定性诊断,结合术后病理资料进行对比研究,分析其MRI表现及主要特点。结果43例病例MRI诊断为甲状腺癌,术后病理证实38例,阳性率88%;其中37例形态不规则,呈分叶状;28例信号不均匀,病理上显示肿瘤出现不同程度的坏死;33例肿瘤边缘模糊,其中26例出现不完整包膜样低信号影,病理发现肿瘤已侵犯并突破假包膜;26例肿瘤侵犯周围组织器官,23例出现颈部淋巴结转移。结论肿瘤形状不规则、信号不均匀是甲状腺癌的MRI特点,而瘤周不完整包膜样低信号影是甲状腺癌MRI的特征性表现;MRI检查能发现一些小肿瘤,明确肿瘤是否侵犯周围组织器官及有无颈部淋巴结转移等,对临床分期评价及选择合适的治疗方案有重要意义。

MRI diagnosis of patients with thyroid carcinoma

Objective It is to analyze the MRI manifestation and histopathological features of thyroid carcinoma,and to investigate the diagnostic value of MRI in thyroid carcinoma.Methods Fifty cases which were diagnosed in clinical or highly suspected to be of thyroid carcinoma were chosen to accept preoperational MRI examination.The manifestations and main feature of MRI were analyzed through comparing the results of their MRI with postoperational pathological findings.Results 43 cases were identified to be of thyroid carcinoma,38 cases were positive,the positive rate was 88%;among the 38 cases,37 cases showed irregular shapes,28 cases showed inhomogeneous signal intensity and pathological examination showed the tumors underwent necrosis;33 cases showed obscure margin,among which 26 cases showed discontinuous capsule-like sign with low signal intensity around the tumor in MRI and that pseudocapsules had been penetrated and partially destroyed by tumors in histopathological findings;26 cases showed the tumor infiltrated the adjacent structures,23 cases showed metastatic lymphadenopathy on the neck.Conclusion Irregular shape and inhomogeneous signal intensity are the expression of thyroid carcinoma in MRI,and discontinuous capsule-like sign with low signal intensity around the tumor is the characteristic manifestation of thyroid carcinoma in MRI;the examination in MRI is able to discover some small tumors,define whether the tumor has infiltrated the adjacent structures and whether there is metastatic lymphadenopathy on the neck.It is important for evaluating the clinical stage and choosing an appropriate treatment.