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甲状腺癌的CT诊断
引用本文:罗德红,石木兰,罗斗强. 甲状腺癌的CT诊断[J]. 中华放射学杂志, 1998, 32(11): 758-760
作者姓名:罗德红  石木兰  罗斗强
作者单位:中国医学科学院中国协和医科大学肿瘤医院放射诊断科
摘    要:目的分析甲状腺癌及其颈部转移淋巴结的CT表现,探讨肿瘤侵犯周围重要器官的诊断指征。方法回顾性分析经手术及病理证实的52例甲状腺癌的术前CT表现。结果52例原发肿瘤均密度不均,32例边缘不规则(82.5%),11例原发肿物及5例转移淋巴结内有细颗粒状钙化,4例原发肿瘤及6例转移淋巴结内有囊性变伴囊壁高密度乳头状结节,手术证实气管受侵22例;10例CT示气管内壁呈锯齿状,5例肿物突入气管腔内而明确诊断。食管受侵21例,颈动脉受侵10例。以肿物包绕食管1/2周或颈动脉1/3周以上为侵犯的诊断指标,敏感性分别为71.4%、100.0%;特异性分别为96.3%、95.2%。结论原发肿物及转移淋巴结内颗粒状钙化及囊性变伴高密度乳头状结节是甲状腺癌(特别是乳头状癌)的特征性密度变化。CT增强扫描对诊断甲状腺癌及评价其与周围结构的关系和制定手术方案十分重要

关 键 词:甲状腺肿瘤  体层摄影术.X线计算机

CT diagnosis of thyroid carcinoma
Luo Dehong,Shi Mulan,Luo Douqiang. CT diagnosis of thyroid carcinoma[J]. Chinese Journal of Radiology, 1998, 32(11): 758-760
Authors:Luo Dehong  Shi Mulan  Luo Douqiang
Affiliation:Luo Dehong,Shi Mulan,Luo Douqiang. Department of Diagnostic Radiology,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing Union Medical University,Beijing 100021
Abstract:Purpose To study the CT appearances of thyroid carcinoma and its cervical metastatic lymphadenopathy, as well as to evaluate the diagnostic criteria of tumor invasion of adjacent structures. Methods CT findings of surgery and pathology proved thyroid carcinoma in 52 patients were analyzed. Results All of the primary tumor were heterogeneous in density, 32 tumors (82.5%) were ill defined. Fine granular calcifications were revealed in 11 primary tumors and metastatic lymph nodes in 5 cases. Cystic formation with intracystic high density papillary like nodules were found in 4 primary tumors and metastatic lymphadenopathy in 5 cases. Trachea, esophagus and carotic artery invasion were proved by surgery in 22, 21 and 10 cases respectively. Serrated inner wall and tumor nodule protrusion into tracheal lumen were the definite signs of trachea invasion. Use tumor encasement over 1/2 of the circumference of esophagus and 1/3 of the circumference of carotid artery as the diagnostic criterion of invasion, sensitivity was 71.4%, 100.0%; specificity was 96.3%, 95.2% respectively. Conclusion Fine granular calcification and cystic formation with high attenuaion intracystic papillary like nodules were characteristic manifestations of primary thyroid carcinoma (especially papillary carcinoma) and its metastatic lymphadenopathy as well. Contrast enhanced CT scan is helpful in the diagnosis of thyroid carcinoma and the delineation of tumor extent, which is very important in surgical planning.
Keywords:Thyroid neoplasms Tomography   X ray computed
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