甲状腺癌的CT与彩色超声检查比较

Comparision between CT scan and doppler ultrasonography used in diagnosis of early stage thyroid cancer

目的 观察甲状腺癌的CT与彩色超声表现,评价两种不同检查方法对甲状腺癌的诊断意义. 方法 回顾性分析经手术病理证实为甲状腺癌的23例患者资料,均已行CT扫描和/或彩色超声检查. 结果 220例甲状腺包块患者中接受颈部CT检查140例,共检出甲状腺癌患者13例,病例证实9例,准确率69.2%（9/13）;接受甲状腺彩色超声检查158例,共检出甲状腺癌患者18例,术后病例证实16例,准确率88.9%（16/18）;其中行两项检查患者为78例,检出甲状腺癌患者8例,术后病理确诊7例,符合率为87.5%（7/8）. 结论 甲状腺癌术前行彩色超声检查的检出率与CT检查无明显区别,作为一种无辐射、可重复进行的检查手段,甲状腺疾病患者可常规进行术前彩色超声检查.但对于多发结节合并存在甲状腺癌的患者,CT及彩色超声检查均难以检出.

Objective To investigate the results of CT scan and Doppler ultrasonography in thyroid cancer,and to evaluate the diagnostic significance. Methods We retrospectively reviewed the CT scan and Doppler ultrosonography of 23 patients with thyroid cancer confirmed by postoperative pathology. Results One hundred and forty of 220 patients with thyroid nodules had cervical CT scan and 9 patients with thyroid cancer were discovered;while 158 patients had Doppler ultrasonography and 16 thyroid cancers were found.Accuracy of the two diagnostic methods were 69.2%（9/13）and 88.9%（16/18）,respectively.In all patients,78 took both CT and ultrasonography,and positive rate was 87.5%（7/8）. Conclusions There is no significance difference in detectable rate with preoperative Doppler ultrasonography and CT scan.We recommend Doppler ultrasonography which has no radiation and duplicable as a routine preoperative test taken by thyroid disease patients.However,it is difficult for both CT and Doppler ultrasonography to detect thyroid cancer concomitant with multiple nodules.