甲状腺结节样病变的MSCT诊断价值

摘要

目的 分析甲状腺结节样病变的多层螺旋CT(multi-slice spiral CT,MSCT)影像学特点,探讨MSCT鉴别甲状腺结节病变的价值.方法 回顾性分析经手术病理证实的66例甲状腺病变患者扫描资料,从结节的形状、边缘、强化行为、钙化、增大的淋巴结及肿瘤与周围结构的关系方面总结甲状腺结节病变的CT表现,用Stata10.1软件进行统计学处理.结果 甲状腺癌与甲状腺腺瘤、结节性甲状腺肿组间病变形状是否规则、边缘是否清晰、颈部是否有淋巴结肿大、对周围组织是推压还是侵犯经χ2检验表明差异具有显著性(P<0.05);病变钙化率及增强检查后密度是否均匀的比较差异无显著性(P>0.05),但钙化的大小、形态、无强化低密度区及乳头状强化结节各有其特点,有鉴别诊断意义.良性病灶无强化低密度区均匀、细腻,甲状腺癌呈混杂性,犹如液体中漂有悬浮物.良性病灶乳头状强化结节边缘圆钝,恶性则较锐利.结论 掌握各种甲状腺结节样病变的MSCT表现特点能有效地提高诊断的准确性,为临床制订治疗方案提供重要依据.%Objective To summarize the multi-slice spiral CT findings of thyroid nodules and to evaluate the diagnostic value of MSCT for the thyroid nodules diseases. Methods MSCT data in 66 cases with thyroid disease confirmed by surgery and pathology were retrospectively analyzed, the MSCT features including shape, margin, enhancement behavior, calcification, cervical lymph node enlargement and the delineation of tumor were analyzed and dealed by Stata10. 1 software. Results There were statistically significant differences between thyroid carcinoma, thyroid adenoma and nodular goitre in shape, margin, cervical lymph node enlargement and the delineation of tumor (P＜0.05 ). The calcification ratio and the density on contrast-enhanced scan between them were no statistic significance(P＞0. 05 ), but the characteristics of size and shape of calcification, low dense area without enhancement and papillary nodular enhancement behavior were useful for differential diagnosis, low dense area without enhancement in benign lesion showed homogeneous and exquisite, but linkage heterogeneity in malignant lesion , mimic suspended matter in fluid. The margin of papillary enhanced nodular was blunt in benign lesion, sharp in malignant. Conclusion Mastering the MSCT features of various thyroid nodules can improve the accuracy of differential diagnosis , which provide important information for clinical treatment planning.