结节性甲状腺肿的CT鉴别诊断与病理学对照研究

Differential Computed Tomography of Nodular Goiter Against Pathological Examination

目的探讨结节性甲状腺肿的CT鉴别诊断及其病理学表现特点。方法回顾性分析58例甲状腺病变的CT资料,本组病例均经病理证实,扫描层厚及层间距均为3 mm,扫描范围取颈部侧位像从甲状软骨中部至颈根部,部分病例行平扫加增强扫描。结果本组中结节性甲状腺肿30例(占52%),甲状腺腺瘤20例(占34%),甲状腺腺癌8例(占14%);30例结节性甲状腺肿均表现为平扫甲状腺肿大,病变腺叶边缘清晰,周围脂肪间隙存在,腺叶内部密度不均匀,见多发、大小不等、边缘规整的低密度结节影;22例结节性甲状腺肿以右侧叶为主,5例以左侧叶病变为主,3例累及甲状腺峡部;6例结节性甲状腺肿伴钙化,10例伴囊变,4例合并囊变、出血。结论 CT对结节性甲状腺肿的鉴别诊断具有重要意义。

Objective To study the differential computed tomography（CT） of nodular goiter against pathological examination.Methods Fifty-eight patients were retrospectively reviewed to compare CT scan outcomes against pathological outcomes.The slice thickness and slice interval were both 3 mm.The scanning field covered median thyroid cartilage to neck root on lateral view whilst contrast-enhanced scan was performed in some patients.Results In this patient cohort,30（52.0%） was diagnosed with nodular goiter,20（34.0%） with thyroid adenoma,and 8（14.0%） with thyroid adenocarcinoma.In 30 patients with nodular goiter,the lesions manifested on plain scan as swelling thyroid gland,with clear margin,evident fat space,heterogeneous interior density,and multiple,varying-sized,and regular-margin low-density nodules.In 22 patients,nodular goiter mainly involved the right lobe,left lobe in 5 patients,and isthmus in 3 patients.Concurrent calcification occurred in 6 patients,cystoid change in 10 patients,and hemorrhagic cystoid change in 4 patients.Conclusion CT scan helps to differentiate nodular goiter.