多排螺旋CT诊断甲状腺癌的影像学特点分析

Analysis of imaging features of multi-slice spiral CT in diagnosis of thyroid cancer

目的:分析多排螺旋CT诊断甲状腺癌的影像学特点。方法:回顾性分析2017年1月至2019年3月收治的40例甲状腺癌患者的临床资料,所有患者均进行多排螺旋CT检查,分析多排螺旋CT诊断结果及不同类型甲状腺癌的CT影像特点。结果:多排螺旋CT与病理诊断结果比较,差异无统计学意义(P>0.05);本组40例甲状腺癌患者,CT检出乳头状癌22例,可见瘤体形态不规则,与周围组织分界不清,呈不均匀低密度影,内部可见密度更低的坏死区及散在钙化灶,增强扫描可见明显、不均匀强化;髓样癌3例,瘤体呈弥漫性均匀低密度肿块,且肿块轻度增强,一般累及一叶甲状腺,淋巴结转移呈明显增强;滤泡癌7例,肿块大,形态规则,强化程度低,内部可见星芒状瘢痕或坏死,有环状、间断钙化;未分化癌3例,为低密度肿物,呈条带状、絮状、斑片状高密度区,轻中度强化,可见不完整环状、蛋壳状钙化或周围结构侵犯。结论:多排螺旋CT诊断甲状腺癌的符合率较高,且不同类型甲状腺癌多排螺旋CT检查的影像学特点各异。

Objective: To analyze imaging features of multi-slice spiral CT in diagnosis of thyroid cancer. Methods: The clinical data of 40 patients with thyroid cancer admitted from January 2017 to March 2019 were retrospectively analyzed. All patients underwent multi-slice spiral CT examination. Then, the diagnosis results of multi-slice spiral CT and the imaging features of different types of thyroid cancer were analyzed. Results: There was no statistically significant difference between the multi-slice spiral CT and the pathological diagnosis result(P>0.05). In this group of 40 patients with thyroid cancer, 22 cases of papillary carcinoma were detected by CT, which showed irregular tumor morphology, unclear boundary with the surrounding tissue was unclear, an uneven low-density image, visible lower density necrotic area and scattered calcifications inside, and obvious and uneven enhancement enhanced scan area;3 cases of medullary carcinoma, which showed a diffuse uniform, slightly enhanced and low-density mass, generally involving a lobe of the thyroid, and significantly enhanced lymph node metastasis;in 7 cases of follicular carcinoma, which showed large, regular shape, and less enhanced mass with visible star inside and ring-shaped and intermittent calcifications;and 3 cases of undifferentiated carcinoma, showing low-density mass and stripped, flocculent and patchy high density area;slight and moderately enhanced;and visible incomplete ring and eggshell calcification or involvement of surrounding structures. Conclusions: The coincidence rate of multi-slice spiral CT in the diagnosis of thyroid cancer is high, and different types of thyroid cancers have difference imaging features.