CT在甲状腺结节良恶性鉴别诊断中的作用研究

摘要

Objective: To study CT value in the differential diagnosis of benign and malignant thyroid nodule. Methods: CT expression of 105 patients with thyroid nodules (136 nodules) diagnosed by operation and histopathological examination were analyzed retrospectively from January 2002 and December 2010. The differences between benign and malignant thyroid nodules were compared. Results: Most benign nodules were multiple, low density nodules, the appearance was regular, they were island and strengthen nodules changes, solid nodules were moderate strengthening, the thickness of strengthening ring was uneven on the edge, nodules around and wall was smooth and sharp, there was a clear demarcation with the surrounding tissue; More malignant nodules were single, low density nodules, density was uneven, shape was irregular, edge was fuzzy, there was irregular necrotic area in them, there was strengthen incomplete circle around the nodules, there was not a clear demarcation with the normal tissue, infiltrating into around thyroid organs and cervical lymph nodes metastasis could happened. The differences of benign and malignant thyroid nodules in diameter, density and density of enhanced scan were no statistics significant (P>0.05). Compared with postoperative pathological diagnosis, the differences of benign and malignant thyroid nodules in shape, boundary, envelope, and calcification were statistics significant (P<0.05), the differences of weather the wall nodules were not statistics significant (P>0.05). Conclusion: Nodule density, shape, boundary, envelope and calcification are important in the differential diagnosis of benign and malignant thyroid nodule.%目的:探讨CT在甲状腺结节良恶性鉴别诊断中的价值.方法:回顾性分析2002年1月~2010年12月经手术及病理组织学检查确诊的105例甲状腺结节患者(136个结节)CT表现,分析良恶性甲状腺结节CT表现及征象差异.结果:良性结节多为多发低密度结节,外形规则,可呈岛状强化结节改变,实性结节中度强化,边缘可见厚薄不均强化环,结节周围及壁光滑锐利,与周围组织分界清楚;恶性结节多为单发低密度结节,密度不均,形状不规则,边缘模糊,内有不规则坏死区,结节周围有强化残圈,与正常组织分界不清,可发生甲状腺周围器官组织浸润和颈部淋巴结转移.良恶性甲状腺结节在结节大小、密度及增强扫描时的密度无明显差异(P>0.05).与手术病理对照分析表明,良性及恶性甲状腺结节在结节形态、形状、边界、是否有包膜和钙化等方面的差异具有统计学意义(P<0.05),而在是否有壁结节方面的差异无统计学意义(P>0.05).结论:结节密度、形态、边界、有无包膜及钙化对甲状腺结节良恶性鉴别诊断具有重要意义.