结节性甲状腺肿的128层CT征象与病理表现的关系探讨

摘要

目的:研究结节性甲状腺肿(NG)的NeuViz 128层CT征象与病理表现关系,以提高NG的诊断准确率.方法:选取在医院就诊的33例NG患者,回顾性分析患者术前128层CT表现,并与术后病理结果进行对照研究.结果:在33例患者中共检出76个NG结节,其中囊性结节7个、实性结节18个、囊实性结节51个;28例患者为多发结节(占85%),其中结节包膜不完整67个(占88%)、钙化32个(占42%),15个(占20%)出现纤维化.增强扫描后显示,7个结节内无强化(4个结节周围见环形强化),4个结节轻度强化,8个结节中度强化,57个结节重度强化;在69个强化的结节中,均匀性强化9个,结节样强化27个,灶内岛状强化21个,灶内无规则不均匀强化12个.病理学证实NG为胶质潴留结节、增生结节或混合性结节,并伴囊变坏死、出血、纤维分隔以及粗大钙化,对应其CT表现分别为囊性结节7个,实性结节18个,囊实性结节51个.结论:NeuViz 128层高端CT能够清晰地反映NG多样的病理学表现,通过对CT轴位扫描及三维后处理征象分析,可以反映NG的病理学表现,有助于提高诊断准确率.%Objective: To research the relationship of image features with 128-slices CT (NeuViz 128 slices) and pathological diagnosis on the nodular goiter(NG) so as to increase the accuracy rate of diagnosis for NG. Methods:33 patients with NG were enrolled in the research. And the preoperative CT features with 128-slices of them were analyzed by using retrospective analysis, and these signs were compared with postoperative pathological results by using comparative study. Results: Total 76 nodules of NG were found on 33 patients, and there were 7 nodules were cystic nodules, and 18 nodules were solid nodules, and 51 nodules were cystic-solid nodules. And 28 patients have multiple nodules (85%). And in these nodules, there were 67 nodules without complete nodule capsule (88%), and there were 32 nodules have been calcified (42%), and 15 nodules were fibrosis (20%). The results of enhancement scan indicated that 7 nodules were not enhanced ( the circular enhancement could been found around 4 nodules), and 4 nodules were slightly enhanced, 8 nodules were moderately enhanced and 57 nodules were significantly enhanced. And in the 69 enhanced nodules, 9 nodules were uniform enhancement, and 27 nodules were nodular enhancement, and 21 nodules were island - shaped enhancement within lesion, and 12 nodules were irregular and non-uniform enhancement. The results of pathological detection indicated that these NG were colloid storage nodules, hyperplasia nodules or mixed nodules, and all of them were companied with necrosis and cystic lesions, bleeding, fibrous separation and bulky calcification. And the corresponding CT appearances could been divided into cystic nodules(7 nodules), solid nodules (18 nodules) and cystic-solid nodules (51 nodules). Conclusion: NeuViz 128 slices CT can clearly appear the pathological manifestation of NG. And through analyzed the axial scan of CT and 3D post-processing signs, the pathological manifestation could been reflected, and they can contribute to increase accuracy rate of diagnosis.