256层CT双期增强扫描在甲状腺腺瘤和甲状腺癌鉴别诊断中的价值

The value of 256-slice CT dual-phase enhanced scanning in the differential diagnosis of thyroid adenoma and thyroid cancer

目的:探讨256层CT双期增强扫描在甲状腺腺瘤和甲状腺癌鉴别诊断中的价值。方法:回顾性比较29例经手术后病理证实的甲状腺腺瘤和甲状腺癌患者CT平扫及增强扫描结果。结果:29例患者共取出甲状腺结节33枚(甲状腺腺瘤20枚、甲状腺癌结节13枚)。甲状腺腺瘤组4例钙化,13例结节边缘清楚,包膜完整。增强扫描病灶实性成分13例明显强化,2例轻度强化,5例完全囊变病灶无强化,15例强化病例中9例强化均匀,6例强化不均匀。7例颈部出现增大淋巴结,增强后无强化。甲状腺癌组5例出现钙化,均位于结节中心,4例呈多发砂粒状,1例呈单发结节状。1例结节边缘清楚,12例不清楚,其中5例突破包膜。增强扫描病灶实性成分均为明显强化,2例强化均匀,11例强化不均匀。12例颈部出现明显肿大淋巴结,增强后均表现为明显不均匀强化。4例出现周围组织侵犯。甲状腺腺瘤和甲状腺腺癌在钙化形态及位置、边缘是否清楚、强化是否均匀、是否突破包膜、有无肿大淋巴结及淋巴结强化、周围侵犯等方面差异显著(P<0.05)。结论:256层CT双期增强扫描对甲状腺腺瘤和甲状腺癌在鉴别诊断上可以提供重要的依据。

Objective To explore the value of 256-slice CT dual-phase enhanced scanning in the differential diagnosis of thyroid adenoma and thyroid cancer. Methods The CT plain scan and enhanced scan results of 29 patients with pathologically confirmed thyroid adenoma and thyroid cancer after operation were retrospectively compared. Results Total of 33 thyroid nodules(20 thyroid adenomas and 13 thyroid cancer nodules) were removed from 29 patients. In the thyroid adenoma group, there were 4 cases of calcification and 13 cases of nodules with clear margins and intact capsule. In the thyroid cancer group, calcification occurred in 5 patients, all of whom were located in the nodules, 4 of whom presented multiple arenaceous granules, and 1 of whom presented single nodules. Thyroid adenoma and thyroid adenocarcinoma showed significant differences in calcification morphology and location(P<0.05). Conclusion Two-phase enhanced 256-slice CT scan can provide important basis for the differential diagnosis of thyroid adenoma and thyroid cancer.