| 部分囊性乳头状甲状腺癌与结节性甲状腺肿的CT鉴别诊断 |
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| 引用本文： | 王东侠,舒艳艳,韩志江,徐锦华.部分囊性乳头状甲状腺癌与结节性甲状腺肿的CT鉴别诊断[J].海南医学,2014,0(11):1624-1627. |
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| 作者姓名： | 王东侠 舒艳艳 韩志江 徐锦华 |
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| 作者单位： | 王东侠(北京市丰台中西医结合医院放射科,北京,100072)； 舒艳艳 (杭州市萧山区第一人民医院放射科,浙江 杭州,311200)； 韩志江 (杭州市第一人民医院放射科,浙江 杭州,310006)； 徐锦华(北京市丰台中西医结合医院消化内分泌科,北京,100072)； |
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| 基金项目： | 2012杭州市卫生科技计划项目(编号2012A020)；2013杭州市重大科技创新专项项目(项目编号：编号20131813A08) |
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| 摘 要： | 目的探讨甲状腺部分囊性乳头状癌（Partially cystic papillary carcinoma,PCPC）与部分囊性结节性甲状腺肿（partially cystic nodular goiter,PCNG）的CT鉴别诊断。方法回顾分析经组织学证实的8例8枚PCPC和26例27枚PCNG的CT资料,观察结节内微钙化、乳头状结构、结节形态、壁结节数目及形态在PCPC和PCNG中的分布,统计微钙化、乳头状结构、结节形态不规则、单发壁结节对PCPC诊断的敏感性、特异性、阳性预测值和准确度。结果微钙化、乳头状结构、结节形态不规则及单发壁结节均好发于PCPC中（P〈0.05）,其敏感性分别为75%、75%、75%、100%,特异性分别为100%、70.4%、95.6%、88.9%,阳性预测值分别为100%、42.9%、75.0%、72.3%,准确度分别为94.3%、71.4%、88.6%、91.4%。3枚弧形钙化均见于PCNG中。结论结节内微钙化、乳头状结构、结节形态不规则、单发壁结节等对PCPC的诊断具有重要价值,而形态规则、多发壁结节/环状或半环状壁结节、弧状钙化有助于PCNG的诊断。
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| 关 键 词： | 部分囊变结节 部分囊变乳头状癌 囊性乳头状癌 甲状腺结节 体层摄影术 X线计算机 |
Value of computed tomgraphy in determining the nature of partially cystic papillary thyroid carcinoma and partially cystic nodular goiter |
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| Institution: | WANG Dong-xia , SHU Yan-yan , HAN Zhi-jiang , XU Jin-hua ( 1. Department of Radiology, Hospital of Integrated Traditional Chinese And Western Medicine of Fengtai Area of Beijing, Beijing 100072, CHINA; 2. Department of Radiology, First People ＇s Hospital of Xiaoshan Area of Hangzhou, Hangzhou 311200, Zhejiang, CHINA; 3. Department of Radiology, First People＇s Hospital of Hangzhou, Hangzhou 310006, Zhejiang, CHINA; 4. Department of Digestive and Endocrine Department, Hospital of lntegrated Traditional Chinese And Western Medicine of Fengtai Area of Beijing, Beijing 100072, CHINA) |
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| Abstract: | Objective To assess the value of computed tomgraphy in determining the nature of partially cystic papillary thyroid carcinoma（PCPC） and partially cystic nodular goiter（PCNG）. Methods CT data of 8 lesions from 8 patients with PCPC and 27 lesions from 26 patients with PCNG were retrospectively analyzed, and all of the patients had pathology diagnosis. The distribution of microcalcifications, papillary structures, nodule shape, number and shape of wall nodule in PCPC and PCNG were observed. And the sensitivity, specificity, positive predictive value and accuracy of microcalcifications, papillary structures, irregular shape, single wall nodule for the diagnosis of PCPC were analysed. Results Microcalcifications, papillary structures, irregular shape and single wall nodule were more common in PCPC, and the sensitivities were 75%, 75%, 75% and 100%, respectively, and the specificities were 100%,70.4%, 95.6% and 88.9%, respectively, and the positive predictive values were 100%, 42.9%, 75.0% and 72.3%, respectively, and the accuracies were 94.3%, 71.4%, 88.6% and 91.4%,respctively. 3 leisions with arc calcifications were found in PCNG. Conclusions Microcalcifications, papillary structures, irregular shape, single wall nodule are important for the diagnosis of PCPC, and regular shape, multiple wall nodule/annular wall nodule or half-annular wall nodule and arc calcifications are helpful for the diagnosis of PCNG. |
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| Keywords: | Partially cystic nodule Partially cystic papillary carcinoma Cystic papillary carcinoma Thyroid nodule X-ray computed tomography |
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