结节状甲状腺肿患者的CT图像分析

CT image analysis for patients with nodular goiter

目的探讨结节性甲状腺肿(NG)的CT图像特征,为临床正确诊断提供指导和依据。方法选取2014年2月~2017年2月我院收治的经手术病理证实的63例NG患者,对患者的CT图像进行回顾性分析。结果63例NG患者的CT平扫图像均表现为甲状腺肿大,有低密度的圆形或类圆形结节影,增强扫描的图像可见密度多呈不均匀强化。63例中,31例病灶内有钙化(49.21%);52例病灶边缘清晰(82.54%);有47例结节呈弥漫型分布(74.60%),其中单侧病变31例,双侧病变16例;有16例结节呈局限型分布(25.40%),其中单发结节5例,多发结节11例;21例伴有囊变(33.33%),10例伴有气管受压变形(15.87%),5例伴有病灶突入胸骨(7.93%),8例伴有颈部淋巴结节肿大(12.70%),增强扫描可见均匀强化。结论 CT扫描尤其是增强扫描能够清晰显示病灶的边缘是否规则、钙化形态及强化特点,对于NG诊断具有较高的准确性,并且能对病灶与周围结构间的关系进行评价,在NG的诊断及鉴别中具有重要价值。

Objective To explore the characteristics of CT images of nodular goiter in order to provide guidance and ba- sis for correct clinical diagnosis.Methods From February 2014 to February 2017,63 patients with nodular goiter con- firmed by surgical pathology were selected.CT images on these participants were retrospectively analyzed.Results CT scan images were all displayed with thyroid enlargement accompanied by low density round or quasi-circular shadow. The images were mostly presented with uneven enhancement by enhancement scan.Of the 63 patients,calcification in lesions was 31 （49.21%）,and clear margin was 52 （82.54%）.There was 47 （74.60%） nodules in diffuse distribution and 16 cases in restricted distribution.For the former,31 cases were with unilateral lesions and 16 ones were in bilateral.For the latter,5 cases were with single nodules and 11 ones were presented with multiple nodules.Among all selected im- ages,21 cases were accompanied with cystic degeneration （33.33%）,10 ones with tracheal deformation due to compres- sion （15.87%）,5 with lesions into the sternum （7.93%）,and 8 with enlarged cervical lymph nodes （12.70%）.Homoge- neous enhancement was visible by enhancement scan.Conclusion CT scan especially enhancement scan can clearly show whether the edge of the lesion is regular,calcified form,and enhanced features with a high accuracy for the diag- nosis of nodular goiter.In addition,it can evaluate the relationship between the lesion and its surrounding structure and has an important value in the diagnosis and identification of patients with nodular goiter.