多层螺旋CT对甲状腺良、恶性病变的诊断价值

The diagnostic value of the multi-slice helical CT in the differentiation of benign and malignant thyroid lesions

目的探讨多层螺旋CT扫描对甲状腺良、恶性疾病的诊断与鉴别诊断的价值。方法回顾性分析经手术病理证实的67例甲状腺病变的CT表现。结果甲状腺癌31例,结节性甲状腺肿24例,甲状腺腺瘤12例,甲状腺癌患者中合并结节性甲状腺肿5例,合并腺瘤1例,结节性甲状腺肿并腺瘤6例。CT平扫甲状腺病变均以低密度为主。36例甲状腺良性病变,密度均匀9例,不均匀27例,9例出现钙化,颈部淋巴结肿大16例;动脉期32例呈明显不均匀强化,延时期强化程度稍减低,密度趋于均匀。31例甲状腺癌,密度均匀12例,不均匀19例,13例出现钙化,钙化形态多样,颈部淋巴结肿大23例;动脉期23例呈明显不均匀强化,延时期强化程度减低,CT值下降幅度>21%。结论采用多层螺旋CT扫描,对鉴别甲状腺良、恶性病变具有一定的价值。

Objective To investigate the value of multi-slice helical CT in the differentiation of benign and malignant thyroid lesions. Methods CT imagings of 67 cases with pathologically proven thyroid lesions were analyzed retrospec- tively. Results Among the 67 cases, 31 were thyroid carcinoma, 24 were nodular goiter, 12 were thyroid adenomas, thyroid carcinoma with nodular goiter 5, thyroid carcinoma with adenoma 1, and nodular goiter with adenoma 6. All 67 cases of theroid lesions were lower-density in CT scanning principally. Among 36 cases of benign lesions, 9 showed homogeneous density, 27 showed heterogeneous dencity, 9 of them had calcification, 16 had enlarged cervi- cal lymph nodes, 32 of them were obvious enhancement uneven in artery time, the density was reduced gently and even gradually in venous. Among 31 cases of thyroid carcinoma, 12 showed homogeneous density, 19 showed hetero- geneous dencity, 13 of them had various shape calcification, 23 had enlarged cervical lymph nodes, 23 of them were obvious enhancement uneven in artery time, the density reduced in venous, which CT value reduced more than 20 Hu. Conclusion MSCT scan has a certain value in differential diagnosis of benign and malignant thyroid lesions.