甲状腺病变的CT诊断（附30例分析）

CTdiagnosisofthyroiddiseases(analysisof30cases)

目的：观察甲状腺病变的ＣＴ表现，重点研究ＣＴ检查对病变良恶性定性诊断的作用。材料与方法：总结３０例各种甲状腺病变的ＣＴ表现，并将其分为三大类型（局限型、弥漫肿大型、混合型）进行分析。结果：（１）局限型：８例甲状腺腺瘤，７例结节性甲状腺肿及１例甲状腺癌属此型；（２）弥漫肿大型：２例桥本甲状腺炎，１例Ｇｒａｖｅｓ病属此型；（３）混合型：６例结节性甲状腺肿，４例甲状腺癌属此型。本组病例中有１例为隐匿性甲状腺癌。ＣＴ对恶性组的定性诊断符合率达８３．３％；对良性组的定性诊断符合率为７５．０％。结论：ＣＴ对甲状腺病变的良恶性定性诊断具有很高价值（良性组符合率不够高的主要原因是对病变的ＣＴ表现特点掌握不够）；在判断混合型病变的良恶性时，观察重点应是病变与腺外结构的分界情况而非腺内结构的边缘。并强调了增强扫描对诊断的重要性。

Purpose:ToevaluateCTinthediagnosisofbenignandmalignantlesionsofthyroidgland.Materialsandmethods:TheCTfindingsin30caseswithvariousthyroiddiseaseswereana-lyzedandcouldbeclasifiedintothreetypes(localizedtype、difuseenlargementtypeandmixedtype).Results:(1)localizedtype,including8thyroidadenoma;7multinodulargoiterand1thyroidcarcinoma;(2)difuseenlargementtype,including2Hashimotothyroiditisand1Gravesdisease;(3)mixedtype,including6multinodulargoiterand4thyroidcarcinoma.Therewasonecaseofoc-cultthyroidcarcinoma.Inourseries,theacuracyofCTdiagnosiswas96.7%formalignantlesionsand75.0%forbenignlesions.Conclusion:ThebenignormalignantnaturethyroidglandcouldbeidentifiedaccuratelybyCT.ThecauseofrelativelyloweraccuracyofCTdiagnosisinthebenigngroupwaslackofunderstandingoftheCTfeaturesofbenignlesions.Thekeypointofobservationwastheinterfacebetwenthelesionandextraglandstructure,insteadofintraglandstructure,whendecidingthenatureofmixedtype.ItwasstressedthatcontrastenhancementCTisveryimportantindiagnosisofthyroiddiseases.