乳头状甲状腺癌的CT表现与病理对照分析

Comparative Analysis of CT Manifestation and Pathology of Papillary Thyroid Carcinoma

目的探讨乳头状甲状腺癌(papillary thyroid carcinoma,PTC)的CT表现与病理学特点,以提高CT诊断正确率。方法回顾分析经病理证实的16例PTC的CT资料,并与其病理结果进行对比分析。结果 13例为实性,3例为囊实性,肿瘤最大长径为0.75-4.6cm,平均3.3cm。在平扫及增强中,瘤灶密度均低于正常甲状腺组织。6例(37.5%,6/16)病灶内分布颗粒状钙化。13例(81.2%,13/16)显示瘤体边缘模糊及瘤周甲状腺连续性中断。3例(18.8%,3/16)边界清晰,病理为PTC滤泡亚型。4例较小瘤灶(微小癌)强化程度明显低于较大者。结论 PTC具有一定的CT特异征象,结合临床特点及病灶内钙化灶的形态与分布有帮于提高其诊断准确性。

Objective To explore the CT manifestations with corresponding pathologic results of the papillary thyroid carcinomas（PTC） and to improve the CT diagnostic accuracy. Methods The CT findings of 16 PTC patients which confirmed by pathology were retrospectively analyzed and compared with pathological findings. Results In 16 cases,13 cases were solid tumors, and 3 cases contained both solid and cystic components. The maximal diameters of tumors ranged from 0.75 cm to 4.6cm（mean 3.3cm）. Tumor density was lower than that of normal thyroid tissue both on plain and enhanced CT imaging. 6 cases（37.5%, 6/16） contained scattered round granular calcification inside tumors. The margins of tumors were blurry, and the edge of the thyroid around tumors discontinuous in 13 cases. The margins of tumors were distinct in 3 cases which were follicular subtype of PTC in pathology.The enhanced degree of the smaller tumors was significantly lower than the bigger ones in 4 cases. Conclusion Combined with the distribution and form of calcification and the clinical features, the unique CT characteristics of PTC could improve its iagnostic accuracy.