甲状腺隐匿性癌患者30例临床CT表现与病理比较

CT characteristics of occult cancer of thyroid:a report of 30 cases with pathologic correlation

目的探讨甲状腺隐匿性癌(OCT)临床CT、超声的表现,以提升OCT影像学诊断水平。方法回顾我院收治的经手术病理证实的30例OCT患者CT和超声表现。对患者OCT的影像学资料(部位、形态、CT密度或回声、钙化情况等)进行分析,并与OCT的病理结果对照。结果 30例患者病灶共34个(单发27例,双发2例,三发1例)。圆形或类圆形病灶14个,不规则形病灶20个;边缘光整病灶11个,不光整病灶23个;甲状腺边缘连线完整病灶22个,连线中断病灶12个。病灶CT密度或回声均匀,无明显坏死囊变或出血。CT平扫显示低密度病灶21个,等密度病灶13个;超声显示实质性低回声病灶25个,混合性回声9个。CT检查见15个病灶存在钙化,而超声检查仅见9个病灶存在钙化。CT检查见9例患者颈部淋巴结肿大,超声见5例患者颈部淋巴结肿大。结论 OCT的影像表现与其病理特征相关,病灶边缘的不光整、边缘连线的中断、病灶的钙化、颈部淋巴结的肿大等影像学表现有助于OCT的诊断。

Objective To investigate the characteristics of CT and uhrasound on occult cancer of thyroid （OCT） to enhance the imaging diagnosis for OCT. Methods The CT and ultrasound performance of 30 cases of patients with OCT confirmed by pathology in our hospital were retrospectively analyzed. The OCT imaging data （location, shape, CT density or echo, calcification, etc.） were analyzed and compared with pathological findings of the OCT. Results In all 30 patients, there were 34 lesions （single lesions 27 cases, double lesions 2 cases, three lesions 1 case）. Forteen of round or oval shape lesions, 20 of irregularly shaped lesions were; 11 of edge finishing lesions, 23 of entire lesion; 22 of thyroid edge connection complete lesions, 12 of disconnected lesions. CT density or echo of lesion was uniform, no I . obvious cystic necrosis or hemorrhage. CT scan： 21 of low-density lesion, 13 of same density lesions; ultrasound： 25 of substantive hypoechoic lesion, 9 of mixed echo. CT examination showed 15 of calcified lesions, ultrasound examination showed 9 of calcified lesions. CT examination showed 9 cases with cervical lymphadenopathy, by ultrasound examination 5 cases were found. Conclusion OCT imaging characteristics was related to its pathological features, the entire edge, interrupt connection, calcified, and cervical lymph nodes of lesion were helpful for imaging diagnosis of the OCT.