摘要
目的总结39例甲状腺局灶性病变的CT表现,提高CT对此类疾病的诊断价值。方法回顾性分析经手术及病理证实的39例甲状腺局灶性病变共54个病灶的CT表现,分为良、恶性2组,以及囊性,囊实性及实性3种类型。同时取正常人群甲状腺平扫及增强扫描各计100例,作为对照组,计算平均最大强化幅度,与病例组相比较。并对强化后均匀与否、形态及钙化等进行形态学观察。结果(1)恶性组实性病灶的增强扫描强化幅度明显低于良性组及正常人群,差异有显著性(P<0.05),但良性组实性病灶的强化幅度与正常对照组相比差异无统计学意义。(2)以强化幅度50 Hu为界,≥50 Hu的病灶认为是良性,<50 Hu的病灶认为是恶性,其诊断实性病灶良恶性的敏感性为90%,特异性为87%。(3)恶性病变增强以后密度仍比较均匀,而良性病变更多见不均匀强化。(4)囊实性病变中,囊性变中心有岛状实性强化部分及放射状与囊壁相连的索条,牵拉成分叶状,是比较特殊的表现,但仅见于乳头状癌囊性变者。(5)钙化无论是从出现率还是形态上对甲状腺良恶性病变的鉴别并无太大帮助。结论CT检查,尤其是静脉造影剂增强扫描,对甲状腺局灶性病变的良恶性鉴别有一定帮助。
Objectve To improve CT diagnosis of thyroid nedulous lesions by evaluating CT findings of 39 eases of thyroid nedulous diseases, methods CT findings of thyroid nedulous diseases confirmed surgically and pathologically in total 54 loci of 39 eases were reiewed, and divided them into benign and malignant groups ,and cystic, eysti-solid and solid types. Take 100 plain scans and 100 contrast enhanced scans of normal thyroid glands in the study as control. Calculate the max amplification of enhancement of the glands and compare it between the two groups. Observe and calculate the density homogenization, shape, ealelfieation of the benign and malignant lesions with their pathologic findings. Results （ 1 ）The mac enhancement amplification of malignant nodules or masses after contrast enhancement were considerably lower than that of control g＇roup and benign group and were all significant statistic difference （P 〈0.05）. The difference of such amplification between the benign and control group was no statistic significant. （2）With 50 Hu enhancement as a threshold in differentiation malignant （ lower than 50 Hu ）from benign lesions （ higher than 50 Hu ） , the sensitivity was 90% , the specificity was 87%. （3）The enhancement was inclined to be homogeneous in malignant lesions and heterogeneous in benign lesions. （4）A large insular solid part dwelling right in middle of the cyst with some straps connecting to cystic wall,making a lobular appearance,was a specific feature showed only in 2 papillary, carcinoma cases. （5） Neither the incidence nor morphology of the calcifications was of some help in differentiating malignant from benign lesions. Conclusion CT study,especlally that with intravenous contrast enhancement,is of some help in differential diagnosis of benign from malignant thyroid lesions.
出处
《中国厂矿医学》
2006年第5期392-394,共3页
Chinese Medicine of Factory and Mine
