老年甲状腺结节患者钙化形态与分布特征分析

Calcification Morphology and Distribution of Thyroid Nodules in the Elderly

目的探讨甲状腺结节钙化的特点,分析老年甲状腺结节患者钙化形态与分布特征,以提高甲状腺良恶性结节的诊断正确性。方法回顾性分析上海中医药大学附属曙光医院近5年经病理证实的常见的各类甲状腺结节69例,包括甲状腺癌(13例)、腺瘤(22例)、结节状甲状腺肿(34例),年龄60~77岁。分析比较这些疾病中CT影像上的钙化形态及分布特点。结果7例(53.8%)甲状腺癌钙化,不规则分布(细粒样钙化5例,结节状钙化2例),腺瘤5例钙化(22.7%),规则分布(弧形钙化3例,结节状钙化2例),结节状甲状腺肿钙化11例(29.4%),不规则散在分布(弧状钙化6例,结节状钙化5例)。甲状腺癌钙化率与其他组比较差异有统计学意义(P<0.05),细粒样钙化和弧形钙化在良、恶性结节中出现率差异有统计学意义(P<0.05)。结论在老年甲状腺结节患者中,甲状腺癌钙化率最高,以细粒状钙化中心和偏中心分布为主;弧形钙化出现在良性的结节状甲状腺肿和腺瘤中,偏心或边缘分布。3种甲状腺结节中均可出现结节状钙化,无诊断特异性。

Objective To discuss the characteristics of thyroid nodule calcification in the elderly and the morphology and distribution so as to improve the diagnostic accuracy of benign and malignant thyroid nodules.Methods A retrospective analysis was made to the imaging data of 69 cases with thyroid nodules confirmed by pathological study in the past 5 years, including 13 cases with thyroid cancer,22 cases with adenoma,34 cases with nodular goiter,the age of the cases was from 60 to 77 years old;the morphology and distribution characteristics of the diseases on CT images were analyzed.Results Irregular distribution of calcification was found in 7 cases with thyroid cancer (53.8%): fine-grained calcification in 5 cases and nodular calcification in 2 cases;regular distribution was found 5 cases with adenoma (22.7%): curvilinear calcification in 3 cases and nodular calcification in 2 cases;dotted irregular distribution was found in 11 cases with nodular goiters (NG) calcification (29.4%): curvilinear calcification in 6 cases and nodular calcification in 5 cases);there existed a statistical difference in calcification rate between thyroid cancer and other thyroid diseases (P<0.05) while a statistical difference in d etection rate of benign and malignant thyroid nodules between fine-grained calcification and curvilinear calcification.Conclusions Thyroid cancer is of the highest calcification rate in the elderly with thyroid nodules,mainly fine-grained calcifications with central or eccentric distribution;curvilinear calcification are found in benign thyroid nodules and adenoma with in eccentric or marginal distribution;the 3 thyroid nodules may have calcification,which indicates no specificity in diagnosis.