目的 探讨动态增强扫描在甲状腺良、恶性结节诊断与鉴别诊断中的重要性.方法 对85例经手术病理证实的甲状腺结节CT表现特点进行回顾性分析.结果 85例甲状腺结节中,20例为甲状腺腺瘤,其中9例增强早期呈显著均匀强化,6例呈中度强化,5例呈完整环状强化,延迟期15例强化减低,密度均匀.41例甲状腺腺癌中,增强早期34例呈轻到中度不均匀强化,7例呈显著强化,延迟后41例密度不均匀减低.9例强化环不完整,32例无包膜,边界模糊不清楚.13例出现钙化,其中4例为颗粒状,9例为斑块状及结节状.17例合并颈部淋巴结转移癌,其中14例为同侧,2例为双侧,1例位于对侧.24例结节性甲状腺肿中,4例单发肿块,增强早期强化,延迟后仍持续强化,2例单发囊性结节,18例多发囊性结节伴甲状腺肿大,5例为囊壁环形钙化.结论 采取多层螺旋CT动脉期及延迟扫描,在CT表现上,甲状腺良、恶性结节具有一定特征性,结合综合征象,可提高CT诊断与鉴别诊断的准确性.%Objective To explore the value of the multi-slice spiral contrast-CT in the differentiation of benign from malignant thyroid nodules. Methods CT findings in 85 cases with various thyroid tumor diseases confirmed surgically and pathologically were analyzed retrospectively. Results 20 cases of thyroid adenomas,9 of them were significant even improved in enhance early,6 of them were moderate strengthening,5 of them were completely circular strengthen ,15 case with strengthen density reduce and uniform. Among 41 cases of thyroid adenocarcinoma,34 of them were light to moderate uneven improved in early enhancement,? of them were significant improved, the density of 41 case after enhancement was reduced and uneven, 9 of them weren' t completely strengtheningly circular. 32 of them didn' t have diolame, and boundary fuzzy was not clear. 13 of them had calcified, 4 of them performances for granular, 9 of them performances for patches,and nodular. 17 cases of cervical lymph node metastasis, 14 of them were ipsilater-al,2 cases of bilateral, 1 case of them located in the side of neck. 24 cases of thyroid nodular goiter,4 of them were single lumps,and strengthen in enhance early,after delay continued to strengthen,2 cases of single cystic nodule, 18 cases of multiple cystic nodule with thyroid swelling,5 cases of bursa wall annular calcification. Conclusion By means of MSCT arterial and delay scanning, there was some characteristics in thyroid malignant nodules in CT performance, and thus CT diagnosis and differential diagnosis accuracy can be improved by combining the various signs.
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