甲状腺癌骨转移的影像学诊断

Imaging diagnosis of thyroid carcinoma with bone metastasis

目的分析甲状腺癌骨转移的临床及影像学表现,探讨其临床及影像特点和诊断价值。方法经病理证实为甲状腺癌骨转移10例,对其X线、CT表现进行回顾性分析。10例均行X线平片检查,其中3例做CT扫描。结果甲状腺癌具隐匿病史,在骨转移病例,先发现骨转移,后查出原发灶者3例,7例在原发灶或甲状腺结节的基础上出现骨转移。甲状腺癌骨转移以溶骨性转移为主,多发于上半身的骨骼,表现为膨胀性囊状破坏区,呈大片状、地图样骨缺损,范围大、广泛为其特点。结论甲状腺癌可发生骨转移,以溶骨型为主,可有成骨性转移。

Objective To study the clinical and imaging features of thyroid carcinoma with bone metastasis and evaluate the importance of the imaging diagnosis in such cases. Methods A retrospective analysis was performed on the results of X-ray and CT examinations of 10 pathologically confirmed patients (including 2 men and 8 women aged from 40 to 89 years with a mean age of 61 years) with thyroid carcinoma with bone metastasis. Results Thyroid carcinoma was latent in terms of its disease history. In these cases, the primary tumors were identified after the bone metastasis in 3 cases, and the bone metastasis occurred on the basis of the primary lesions or the thyroid gland nodules in 7 cases. Thyroid carcinoma with bone metastasis occurred mostly in the skeleton of the upper body, characterized mainly by cystic expansion of the bone tissue destruction causing extensive patchy map-like bone defects. Conclusion Bone metastasis is common in thyroid carcinoma, manifested typically by bone lysis with occasional osteogenic metastasis.