甲状腺微小乳头状癌CT增强扫描与CT平扫的诊断价值对比研究

Comparative study on the diagnostic value of CT enhancement scan and CT plain scan for PTMC

目的:探讨甲状腺微小乳头状癌(PTMC)CT增强扫描与CT平扫的诊断价值比较。方法:收集医院收治的56例PTMC患者CT扫描资料,所有患者分别采用CT值为42~97 HU的CT平扫和CT值为30~152 HU的CT增强扫描方法,对比分析两种扫描的影像学表现及其诊断价值。结果:经手术病理证实56例患者中共有病灶77枚,CT扫描发现62枚(占80.52%)。在62枚病灶中CT平扫呈低密度52枚,呈等密度8枚,呈钙化状态2枚;CT扫描图像显示病灶密度均匀,未出现囊变及坏死等现象;形态不规则57枚,咬饼征39枚,微钙化8枚及增强后范围模糊58枚。CT增强扫描瘤体呈均匀强化状态,程度低于正常甲状腺组织;出现假包膜征8枚,包膜完整2枚,不完整6枚。结论:PTMC常见的CT征象有平扫低密度,强化均匀且程度低,形态不规则,呈咬饼征,增强扫描后范围模糊等,CT增强扫描有助于发现PTMC的各种CT征象,具有较好的临床应用价值。

Objective: To investigate the comparison of diagnostic value of CT enhancement scan and CT plain scan for papillary thyroid minimal carcinoma(PTMC). Methods: CT scan data of 56 patients with PTMC admitted to hospital were collected. All of patients underwent CT plain scan which CT value was 42 ~ 97 HU and CT enhancement scan which CT value was 30 ~ 152 HU. And the imaging manifestation and diagnostic value of the two kinds of scans were compared and analyzed. Results: There were 77 lesions in 56 patients that were confirmed by surgery and pathology, and 62 lesions were found by CT scan(80.52%). Among the 62 lesions, CT plain scan appeared 52 lesions with low density, 8 lesions with equal density, and 2 cases with calcification. The images of CT scan showed the density of lesion was uniform, and there were not cystic degeneration and necrosis in lesions. And 57 lesions were irregular shape, 39 lesions were bite cookie signs, 8 lesions existed microcalcification and 58 lesions existed fuzzy range post enhancement. CT enhancement scan showed the tumor body was uniformly strengthened, and its degree was lower than that of normal thyroid tissue, and 8 lesions were pseudo-capsule signs, and 2 lesions were complete capsules and 6 lesions were incomplete capsules. Conclusion: The common CT signs of PTMC include plain scan with low density, uniform and low degree of enhancement, irregular shape, bite cookie sign and fuzzy range post enhanced scan. CT enhancement scan is helpful to discover various CT signs of PTMC and has better clinical application value.