CT增强扫描鉴别甲状腺微小结节良、恶性价值

The Value of Enhanced CT Scan in the Differential Diagnosis of Benign and Malignant Thyroid Micro-nodules

目的:探讨CT增强扫描在甲状腺微小结节良、恶性鉴别诊断中的价值。方法:回顾性分析经组织病理学证实的甲状腺单发微小结节90例(共90枚)的CT资料,按照病理结果分为甲状腺微小乳头状癌(PTMC)45例和微小结节性甲状腺肿(MNG)45例,分析CT平扫和双期增强资料。结果:PTMC和MNG在包膜征、强化方式(中心强化和非中心强化)、边缘中断征、钙化、囊变等方面具有统计学差异(P <0.05),在钙化形态方面无统计学差异(P> 0.05)。结论:平扫均匀低密度、包膜征、中心强化、边缘中断征、钙化提示PTMC的诊断;平扫不均匀低或等密度、无包膜征及边缘中断征、边缘结节样、棘状、环状、新月形强化有助于MNG的诊断。CT增强扫描对甲状腺微小结节灶的良、恶性鉴别诊断有重要价值。

Purpose: To evaluate the value of CT-enhanced scan in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: The CT findings of 90 cases histopathological results confirmed single thyroid micro-nodules(90 in total) were retrospectively reviewed. According to pathological results, the features of the CT plain scan and double-phase enhancement of 45 cases of thyroid micropapillary carcinoma(PTMC) and 45 cases of micronodular goiter(MNG) were analyzed. Results: There was statistical difference in the signs of enveloping,strengthening(centralized and non-enhancing), edge disruption, calcification and cystic changes between PTMC and MNG(P<0.05). No statistical difference in calcification shape was found between the two groups(P>0.05).Conclusion: Features of homogeneous low density, capsule sign, center enhancement, edge discontinuity sign,and calcification conduce to the diagnosis of PTMC. Unevenly low or equal density, non-enveloping and marginal discontinuities, marginal nodular/spiky/annular/crescent strengthening contribute to the diagnosis of MNG. CTenhanced scan is of great value in differential diagnosis of benign and malignant thyroid micro-nodules.