影像学对原发性甲状腺恶性淋巴瘤的诊断价值

Significance of Medical Imaging for Primary Thyroid Malignant Lymphoma Diagnosis

目的探讨影像学对原发性甲状腺恶性淋巴瘤(PTML)的诊断价值。方法回顾性分析中国医科大学附属第一医院2000年1月至2014年12月收治的45例PTML患者的影像学资料。结果 PTML甲状腺超声多呈弥漫性低回声或极低回声,其内具有边界清楚的条索样改变,后方回声增强。CT平扫肿物密度低于邻近肌肉,质地较均匀,增强扫描后无明显强化或轻度强化,仍低于或接近邻近肌肉,肿物边缘或内部可见明显强化的条索状区域,钙化和坏死少见。ECT病变部位显像稀疏,呈"凉结节"。结论特征性影像学表现有助于PTML术前诊断。

Objective To evaluate the diagnostic value of medical imaging for primary thyroid malignant lymphomathe（PTML）. Methods The medical imaging of 45 PTML cases admitted between January 2000 and December 2014 in the First Hospital of China Medical University were analyzed retrospectively. Results In ultrasound imaging,PTML exhibits a hypoechoic mass and enhancement of posterior echoes,the uninvolved thyroid tissues also exhibit low echoes but they have clear boundaries with extremely low echo areas of PTML.CT imaging of PTML often shows homogeneous enlargement of the lobes of the thyroid gland and isthmus with densities lower than the adjacent muscles. In contrast-enhanced CT images,lesions are moderately enhanced,but they are obviously enhanced in the edge or internal area and the degree of enhancement remains lower than that of the adjacent muscle. Calcification is uncommon. A lesion with ＂cold nodule＂ can be observed in ECT imaging. Conclusion The characteristic imaging findings are helpful for preoperative diagnosis of PTML.