甲状腺髓样癌的CT表现与病理对照分析

Comparative analysis of CT imaging and pathology in medullary thyroid carcinoma

目的探讨甲状腺髓样癌(MTC)CT影像表现与病理对照。方法选取经病理确诊的20例MTC患者(27枚病灶),均行增强CT检查,比较微小MTC(﹤1 cm)与非微小MTC(≥1 cm)的影像表现及病理特征。结果27枚病灶中,中上极25枚,形态不规则19枚,边界不清17枚,不均匀低密度24枚,钙化10枚,动脉期不均匀低强化24枚,27枚静脉期均为延迟低强化,13枚显示肿瘤血管和不完整包膜,6枚显示“盐和胡椒征”,19枚出现条索/间隔样强化。“盐和胡椒征”在微小MTC与非微小MTC组间差异有统计学意义(P=0.024)。结论MTC大部分位于甲状腺中上极,形态不规则,边界不清;增强扫描出现肿瘤血管、“盐和胡椒征”和条索/间隔样强化时应高度提示MTC的可能。

Objective To analyze the CT findings of medullary thyroid carcinoma(MTC)and to compare them with histopathology.Methods CT findings of 27 lesions in 20 patients with MTC confirmed by pathology were retrospectively analyzed.All patients underwent contrast-enhanced CT examination.The imaging and pathological features of small MTC(<1 cm)and non-small MTC(≥1 cm)were compared.Results Among the 27 MTC lesions,25 were located in the middle-upper thyroid,19 were irregular in shape,17 were unclear in margin,24 were inhomogeneous low density,10 were calcified,24 showed inhomogeneous and mild enhancement in arterial phase,27 showed delayed mild enhancement in venous phase,13 showed tumor vessels and incomplete capsule,6 showed"Salt and Pepper Sign",and 19 showed stripe-like/septal enhancement.The"Salt and Pepper Sign"was significantly different between the small MTC group and the non small MTC group(P=0.024).Conclusion MTC is mostly located in the middle-upper thyroid with irregular shape and unclear margin.The presence of tumor vessels,"Salt and Pepper Sign"and stripe-like/septal enhancement should be highly suggestive of the diagnosis of MTC.