甲状腺乳头状癌的64层螺旋CT诊断

Value of 64-slice spiral CT in the diagnosis of papillary thyroid carcinoma

目的:探讨64层螺旋CT在甲状腺乳头状癌的诊断价值。方法:回顾性分析36例经手术病理证实的甲状腺乳头状癌的64层螺旋CT资料,主要对原发病灶及颈部转移淋巴结的CT表现进行分析。结果:36例均为单发病灶,左叶17例,右叶19例,大部分病灶境界不清楚增强后表现为囊性伴壁结节灶5例,其余表现为不均匀强化,有5例周围可见晕环征,合并钙化者17例,其中细颗粒状钙化4例,粗颗粒状钙化8例,混合性钙化5例。36例患者中30例发生颈部淋巴结转移,增强后淋巴结强化明显,囊性变7例,合并壁结节4例,11例病灶内见钙化,其中细颗粒状钙化4例。结论:甲状腺乳头状癌CT表现有一定的特点,64层螺旋CT多维重建能够更好地评价原发病灶及淋巴结转移。

Objective：To explore the value of 64-slice spiral CT in the diagnosis of papillary thyroid carcinoma. Methods： The 64-slice Spiral CT findings of 36 cases with papillary thyroid carcinoma proved by surgery and pathology were analyzed retrospectively. The image manifestations of primary neoplasm and metastatic lymphadenopathy of neck were analysed. Results：Mass was solitary in all cases, 17 masses were in left lobe, 19 masses were in right lobe, the margin was vague in most cases. After contrast administration, 5 cases showed cyst formation with intracystic high density papillary-like nodules, others showed heterogeneous enhancement, and halo sign was founed in 5 cases. There was calcification in 17 cases, small granular calcification in 4 cases, big granular calcification in 8 cases, and mixed calcification in 5 cases. Lymph noudle metastasis were found in 30 patients including a tocal of 82 metastatic lymph noudles, with cystic formations （n=7）, intracystic nodules （n = 4）, and small granular calcifications （n = 4）. Conclusion.. Characteristic manifestations of PTC were founed on CT images, and multi-plane of 64-slice spiral CT can evaluate the primary lesion and metastatic lymph noudie more correctly.