甲状腺癌、甲状腺腺瘤及结节性甲状腺肿 CT 诊断

目的：探讨CT对甲状腺癌、甲状腺腺瘤及结节性甲状腺肿的诊断价值。方法回顾性分析重庆市九龙坡区第一人民医院55例甲状腺病变的CT表现，其中6例有2种病变并存，甲状腺癌20例，甲状腺腺瘤22例，结节性甲状腺肿15例，评价病灶的部位、数目、密度、边界、强化类型、邻近结构改变及颈部淋巴结情况。结果甲状腺癌、甲状腺腺瘤及结节性甲状腺肿均单侧叶、单发多见，3者间差异无统计学意义（P＞0.05）。甲状腺癌呈稍低密度100％（20/20）及伴钙化75％（15/20），分别高于甲状腺腺瘤64％（14/22）、23％（5/22）及结节性甲状腺肿47％（7/15）、40％（6/15），差异有统计学意义（P＜0.05）。甲状腺腺瘤多数边界清晰91％（20/22），与甲状腺癌35％（7/20）及结节性甲状腺肿60％（9/15）差异有统计学意义（P＜0.05）。80％（16/20）甲状腺癌呈轻度不均匀强化，64％（14/22）甲状腺腺瘤呈显著不均匀强化，2者间差异有统计学意义（P＜0.05）。它们皆可引起邻近结构受压及移位改变，35％（7/20）甲状腺癌可侵犯邻近结构，70％（14/20）甲状腺癌有颈部淋巴结转移。结论甲状腺癌、甲状腺腺瘤及结节性甲状腺肿的CT表现不同，CT具有重要的诊断价值。

CT diagnosis of thyroid carcinoma,thyroid adenoma and nodular goiter

Objective To explore the diagnostic value of CT in thyroid carcinoma , thyroid adenoma and nodular goiter .Methods CT manifestations of 55 cases with thyroid disease were retrospectively analyzed ,among them 6 cases had 2 kinds of lesions , 20 cases had thyroid carcinoma , 22 cases had thyroid adenoma and 15 cases had nodular goiter .The lesions＆#39;location, number, density, margin, enhancement type , neighbor structures chan-ges and cervical lymph nodes were evaluated .Results Thyroid carcinoma , thyroid adenoma and nodular goiter were mainly located in single lobe and solitary , and there were no significant differences among the 3 types（P〉0.05）.All thyroid carcinoma lesions were with slightly low density （100%, 20/20）with calcification 75%（15/20）, which were significantly higher than those of thyroid adenoma 64%（14/22）,23%（5/22）and nodular goiter 47%（7/15）,40%（6/15）respectively.The differences had statistical significance （P〈0.05）.Most thyroid ade-noma had clear margin 91%（20/22）,which had significant differences with thyroid carcinoma 35%（7/20） and nodular goiter 60%（9/15）（P〈0.05）.80%（16/20）of the thyroid carcinoma had inhomogeneous enhancement and 64%（14/22）of the thyroid adenoma had markedly inhomogeneous enhancement .The difference had statisti-cal significance（P〈0.05）.Neighbor structures were compressed and displaced .7 cases（35%,7/20）of thyroid carcinomas invaded neighbor structures and 14 cases （ 70%,14/20 ） had cervical lymph nodes metastasis .Con-clusion CT manifestations of thyroid carcinoma , thyroid adenoma and nodular goiter were different , thus CT has great value in the diagnosis .