原发性甲状腺鳞状细胞癌的CT表现分析

目的分析原发性甲状腺鳞状细胞癌（PTSCC）的CT表现，以提高对该少见疾病的认识。方法回顾性分析经病理证实的16例PTSCC患者的CT资料。结果16例患者中，单侧13例，双侧3例，2例峡部同时受累，共19个病灶。病灶最大径2．1-6．5cm，平均（4．5±0．7）cm；病灶呈类圆形6个，不规则分叶状13个；边界清晰4个，边界不清15个；7个病灶甲状腺包膜完整。12个病灶甲状腺包膜不完整，肿瘤呈浸润性生长，其中5个侵犯食管，3个侵犯颈前带状肌，2个侵犯喉咽。CT平扫病灶呈低密度15个，等密度4个；7个病灶呈实性，12个病灶呈囊实性，6个病灶内见钙化；CT增强病灶呈轻中度强化14个病灶，明显强化5个，其中11个病灶呈环形强化（57．9％）。2例伴有颈部淋巴结肿大。结论老年女性、边缘模糊、坏死明显、少见钙化、轻中度强化、环形强化的甲状腺占位灶，有助于提示PTSCC的诊断，CT检查有助于肿瘤的分期。

Objective To analyze CT features of primary thyroid squamous cell carcinoma and improve the diagnostic level of this rare disease. Methods The CT data of 16 patients with PTSCC confirmed by pathology were retrospectively analyzed. Results There were total 19 lesions in 16 patients. The lesion were unilateral in 13 cases, lesions were bilateral in 3 cases with isthmus involved in 2 cases.The maximum diameter of the lesions ranged from 2.1 to 6.5 cm. of the 19 lesions, 6 were oval round and 13 were lobular. 4 lesions showed dear edge and 15 lesions demonstrated foggy edge. 7 lesions manifested complete envelope and 12 lesions manifested imcomplete envelope, Among them, the esophagus were invaded in five lesions, the strap muscles were invaded in three lesions, the laryngeal pharynx were invaded in two lesions. 15 lesions manifested as low-density and 4 lesions manifested as isodemity on non-enhanced CT.7 lesions displayed solid and 12 lesions displayed solid-cystic appearances respectively. 6 lesions showed calcifications on CT .After intravenous injection of contrast media, 14 lesions demonstrated mild-moderate enhancement, 5 lesions demonstrated remarkable enhancement. Among them, 11 lesions demonstrated ring-like enhancement. Enlarged cervical lymphnodes were found in 2 cases. Conclusion PTSCC should be first indicated when the old women have thyroid masses with foggy edge, obvious necrosis and seldom calcification, accompany with slight to moderate enhancement （ especially ring-like enhancement ） .CT examination are helpful for the staging of tumor.