CT在甲状腺肿瘤鉴别诊断中的应用价值

CT in differential diagnosis of thyroid neoplasms

目的探讨CT在甲状腺良恶性肿瘤诊断及鉴别诊断中的价值。方法经手术后组织病理学证实的39例良恶性甲状腺肿瘤患者，其中男性17例，女性22例，年龄33～78岁，平均年龄45．6岁。行颈部CT平扫8例．增强扫描31例。分析其良恶性甲状腺肿瘤的CT表现，并进行统计学处理。结果7例甲状腺腺瘤平扫时边界清晰．内部主体低密度且密度均匀；3例可见到完整或不完整的囊壁。4例结节性甲状腺肿局限型，低密度影。25例恶性甲状腺肿瘤平扫时成等密度或混杂密度，边界不清，增强扫描强化不均，并向邻近组织侵犯。结论有无对周围组织的浸润、包膜是否完整、边界是否清晰、轮廓是否规则、密度均匀与否及颈部淋巴结有无肿大等特点，对鉴别甲状腺肿瘤良恶性有很大作用。CT在甲状腺肿瘤的诊断和鉴别诊断中具有重要作用。

Objective To study the value of CT in differential diagnosis of thyroid neoplasms. Methods The CT findings of 39 patients with thyroid neoplasms, male 17, female 22, aged 33 - 78 years, mean age 45.6 years, confirmed by the pathology and surgery were analyzed retrospectively. Eight patients were examined by CT scanning, 31 patients were examined by enhanced scanning. Results The CT findings in 7 cases of thyroid adenoma appeared a complete enhanced peril-tumor ring and 3 cases appeared enchanced inner-tumor nodules; 4 cases of nodular goiter showed homogenous density; 25 cases of thyroid carcinoma appeared motley density with unclear edges and adjacent infiltration. Conclusion The invasive and metastatic changes of surrounding structure, the size and shape, margin and density of the lesions, and metastatic lymphadenopathy on the neck are the main points to differentiate diagnosis between benign and malignant thyroid neoplasms. The CT might play an important role in diagnosis and differential diagnosis of thyroid neoplasms.