甲状腺良恶性肿瘤的CT诊断分析

Analysis of CT diagnosis of benign and malignant thyroid tumors

目的 探讨平扫及增强CT检查对甲状腺良恶性肿瘤的鉴别诊断价值.方法 回顾性分析86例甲状腺肿瘤的平扫及增强CT资料,对CT表现和手术、病理结果进行对比分析.86例中良性肿瘤34例,其中甲状腺腺瘤29例,结节性甲状腺肿5例;恶性肿瘤52例,均为甲状腺癌.结果 甲状腺良性肿瘤CT平扫上肿块形状均表现为圆形或类圆形,密度均匀26例（76.5％）,边界清楚31例（91.2％）,钙化6例（17.6％）;甲状腺癌CT平扫表现为肿块形状不规则40例（76.9％）,密度不均50例（96.2％）,边界不清34例（65.4％）,钙化15例（28.8％）.经统计学分析,肿块形状、密度是否均匀,边界是否清楚在甲状腺良恶性肿瘤之间比较差异有统计学意义（P〈0.01）,而是否钙化在两组之间比较差异未见统计学意义（P=0.237）.增强CT扫描甲状腺良性肿瘤,强化26例（76.5％）,与周围脂肪组织边界清楚31例（91.2％）,有气管或血管受压15例（44.1％）,有颈部或颌下淋巴结影9例（26.5％）;甲状腺癌,强化45例（86.5％）,与周围脂肪组织边界清楚18例（34.6％）,有气管或血管受压3例（5.8％）,有颈部或颌下淋巴结影23例（44.2％）.与周围组织边界是否清楚、气管或血管是否受压在甲状腺良恶性肿瘤之间比较差异有统计学意义（P〈0.01）,而是否强化、颈部或颌下有无淋巴结影在甲状腺良恶性肿瘤之间比较差异未见统计学意义,P值分别为0.229、0.096.结论 平扫及增强CT检查对甲状腺良恶性肿瘤的鉴别诊断具有重要的价值.

Objective To investigate the value of plain and enhanced CT examination in the dif-ferential diagnosis of benign and malignant thyroid tumors. Methods The plain and enhanced CT data of 86 cases of thyroid tumor were retrospectively analyzed,there were 34 cases of benign tumors,inclu-ding 29 cases of thyroid adenoma,5 cases of nodular goiter and 52 cases of malignant tumors,which were performed by CT imaging diagnosis,surgery and pathological results. Results CT scan showed that the shape of tumor was round or like round in benign thyroid tumor,the density was homogeneous in 26 cases （76. 5%）,the border was clear in 31 cases （91. 2%）,and calcification in 6 cases （17. 6%）;CT scan of thyroid carcinoma showed irregular shape in 40 cases （76. 9%）,uneven density in 50 cases （96. 2%）,unclear boundary in 34 cases （65. 4%）,calcification in 15 cases （28. 8%）. After statisti-cal analysis,the shape and density of the tumor were homogeneous,and whether the boundary was clear or not was significantly different between benign and malignant thyroid tumors （P 〈 0. 01）,there was no significant difference in calcification between the two groups （P = 0. 237）. Enhanced CT scanning of thy-roid benign tumor enhancement in 26 cases （76. 5%）,and the surrounding adipose tissue of 31 cases with clear boundary （91. 2%）,trachea or vascular compression in 15 cases （44. 1%）,cervical or sub-mandibular lymph nodes in 9 cases （26. 5%）;thyroid cancer was enhanced in 45 cases （86. 5%）,with clear peripheral fat tissue in 18 cases （34. 6%）,tracheal or vascular compression in 3 cases （5. 8%）, and neck or submandibular lymph node shadow in 23 cases （44. 2%）. There was significant difference between the benign and malignant thyroid tumors （P 〈 0. 01）and whether the boundary of the surround-ing tissues was clear or whether the trachea or the vessels were compressed,there was no significant difference between benign and malignant thyroid tumors,whether enhanced or not,and the P values were 0. 229 and 0. 096,respectively. Conclusions Plain scan and enhanced CT scan are of great value in dif-ferential diagnosis of benign and malignant thyroid tumors.