乳头状甲状腺癌CT、MRI表现及与病理对照研究

CT and MRI Findings of Papillary Thyroid Carcinoma and Their Comparison with Pathology

目的 探讨乳头状甲状腺癌(PTC)CT、磁共振成像(MRI)表现及与病理对照结果。方法 回顾性分析2017年6月至2019年7月80例在本院行PTC根治术患者的资料。将患者术前CT、MRI检查结果与术后病理结果进行比较,分析CT、MRI对PTC的诊断价值。结果 80例PTC患者均为单发病灶,其中右侧30例,左侧病灶34例,峡部16例,镜下可见显著乳头状结构,部分混合滤泡状结构,肿瘤边界呈浸润,细胞核体积增大且不规则,排列拥挤。MRI检查中,60.00%(48/80)在T_(1)WI像呈高、稍高信号,T_(2)WI像呈高信号,其中18个病灶在T_(2)WI像中观察到斑片状高信号、6个病灶可在T_(2)WI像中观察到小片状信号,病理上代表小灶性出血和囊变;38.75%(31/80)的病灶在T_(1)WI、T_(2)WI像均呈高信号,其中15个病灶边缘可见凸向内的等信号壁,病理上代表累及背膜的PTC;另有4例为漏诊病例。在CT平扫后,78.75%(63/80)为实性病灶,21.25%(17/80)为囊性病灶,11例病灶可见沙粒样钙化,21例病灶边缘与正常组织出现中断或缺失;其中出现6例误诊,原因在于瘤体直径较小。结论 CT、MRI检查中,PTC有一定的特异征象,可以为肿瘤的早期诊断提供参考。

Objective To explore CT and magnetic resonance imaging(MRI)findings of papillary thyroid carcinoma(PTC)and their comparison results with pathology.Methods The data of 80 patients who underwent radical operation for PTC in the hospital from June 2017 to July 2019 were retrospectively analyzed.The examination results of preoperative CT and MRI were compared with postoperative pathological results.The diagnostic value of CT and MRI for PTC was analyzed.Results All the 80 PTC patients belonged to single lesions,including 30 cases on the right side,34 cases on the left side and 16 cases at the isthmus.There were significant papillary structures and some mixed follicular structures under the microscope.The tumor borders were generally infiltrated,size of cell nucleus was increased and they were irregular.Their arrangement was crowded.In MRI examination,there were 60.00%(48/80)of them showing high and slightly high signal on T_(1)WI image and high signal on T_(2)WI image.There were 18 lesions showing patchy high signal on T_(2)WI image,and 6 lesions showing small patchy signals on T_(2)WI image,which represented small focal hemorrhage and cystic lesions pathologically.There were 38.75%(31/80)lesions showing high signals on T_(1)WI and T_(2)WI images.Among them,there were 15 cases showing convex inward equal signal on the edge,which represented PTC involving notacoria pathologically.And there were 4 cases missing the diagnosis.After CT plain scan,there were 78.75%(63/80)belonging to solid lesions and 21.25%(17/80)belonging to cystic lesions.There were 11 lesions with sand-like calcification and 21 lesions with interruption or absence between their edges and normal tissues.Among them,there were 6 cases misdiagnosed due to short tumor diameter.Conclusion In CT and MRI examination,PTC is accompanied with certain specific signs,which can provide reference for the early diagnosis of tumors.