甲状腺癌的CT诊断与鉴别诊断

目的:分析甲状腺癌的CT表现及鉴别诊断要点。方法:回顾性分析经手术病理证实的83例甲状腺癌和119例甲状腺良性病变的CT表现,归纳总结不同病变的CT特征。结果:83例甲状腺癌中:边界不清62例,不规则坏死59例,囊性变23例,出现“半岛状”强化结节25例,“乳头状”强化结节11例,钙化55例(其中弥漫性钙化27例、局灶钙化28例),侵犯气管15例,颈部或锁骨上淋巴结肿大27例,CT对甲状腺病变的良恶性鉴别诊断符合率93.6%(189/202)。结论:“半岛状”强化结节是甲状腺癌的特征性表现,“乳头状”强化结节及弥漫性钙化可做为甲状腺癌的肯定性征象,掌握各种甲状腺病变的CT表现特点,对病变的定性诊断及鉴别诊断具有重要意义。

CT Diagnosis and Differential Diagnosis of Thyroid Carcinoma

Objective To analyze the CT appearance of thyroid carcinoma and the differential diagnosis of various thyroid disease.Methods 83 cases of thyroid carcinoma and 119 cases of various benign disease with surgical and pathologically proved were analyzed retrospectively.Results The CT findings of 83 cases of thyroid carcinoma include:ill-defined nodules boundary (n=62),irregular necrosis(n=59),cystic(n=23),“peninsula” enhancing tubercles around the tumour(n=25),“mastoid” tubercles around the tumour(n=11),calcification(n=55) including large-scale(n=27) and local(n=28),trachea invasion(n=15),neck or supraclavicular lymph node metastasis(n=27),The accurate of CT to differentia benignancy from malignancy on thyroid disease was 93.6%(189/202).Conclusions “peninsula” enhancing tubercles was the characteristic sing of thyroid carcinoma,“mastoid” enhancing tubercles or large-scale calcification was the affirmative sign,The CT signs was vary useful to differentiating thyroid disease.