慢性淋巴细胞性甲状腺炎的MSCT诊断

MSCT Diagnosis of Chronic Lymphocytic Thyroiditis

目的:探讨慢性淋巴细胞性甲状腺炎(CLT)的MSCT表现及其诊断与鉴别诊断。方法:回顾性分析经手术病理证实的CLT患者56例,其中伴有结节性甲状腺肿17例、甲状腺腺瘤15例和甲状腺癌9例。全部病例均行CT平扫,42例同时增强扫描。结果:CT平扫甲状腺增大49例,腺体密度均匀减低30例,不均匀减低16例;伴有结节或团块37例,其中单发结节24例,多发结节10例,弥漫小结节3例;出现钙化10例、囊变4例。增强扫描病变呈速升缓降型,60sCT值达峰值,然后缓慢下降,强化均匀或不均匀。结论:CLT常合并结节性甲状腺肿、腺瘤和甲状腺癌,MSCT表现有一定特点,帮助诊断及鉴别诊断。

Purpose： To explore the MSCT manifestation, diagnosis and differential diagnosis of chronic lymphocytic thyroiditis （CLT）. Methods： Fifty-six cases of CLT confirmed by operation and pathological result were reviewed, including 17 cases of nodular goiter, 15 cases of thyroid adenoma and 9 cases of thyroid carcinoma. All the cases received plain CT scan, and 42 of them accepted contrast-enhanced scan. Results： Plain CT scan： 49 cases were shown with thyroid goiter, 30 of them were with homogeneous low densities in the thyroid, and 16 cases with non-uniform low densities; 37 cases were shown with nodules or lumps, which included 24 cases with solitary nodule, 10 cases with multiple nodules, and 3 case with diffuse nodules; Calcification was found in 10, and cystoid degeneration in 4. Contrast-enhanced CT scans： CLT was shown with quick ascent and slow decent time-density curve, the CT value of the lesion was increased to maximum at 60＇ s, then was decreased slowly; The enhancement was homogeneous or heterogeneous. Conclusion： CLT often accompanies with nodular goiter, thyroid adenoma and thyroid carcinoma. It has some common features on MSCT, which can be used for diagnosis and differential diagnosis of CLT.