摘要
目的分析甲状腺间变癌的CT表现，评价CT在明确甲状腺间变癌诊断及鉴别诊断中的价值。方法回顾性分析经手术、病理证实的10例甲状腺间变癌的临床及CT资料，女7例、男3例；发病年龄25～78岁，中位年龄为61岁；均采用MSCT行平扫及增强扫描。结果10例中8例为单侧病灶，其中2例病灶较大侵及峡部；2例病灶累及双侧甲状腺。肿瘤最大径为2．9—12．8em，平均（4．5±1．4）Cm；病灶边缘均不光整且有甲状腺被膜外侵征象；病灶平扫密度不均匀，病灶内均可见坏死区；病灶内伴钙化者7枚，钙化形态各异，以单发粗颗粒钙化状较多见（5个病灶）。增强后病灶均呈明显不均匀强化，实性部分明显强化（强化幅度〉40HU）；平扫及增强后病灶与对侧胸锁乳突肌CT值比值分别为0．69～0．82（0．76±0．18），1．25～1．41（1．33±0．28）。伴颈部淋巴结肿大者6例，增强后不规则环形强化或均匀明显强化，1例淋巴结内见砂粒状钙化。结论直径较大、单发、粗颗粒钙化、甲状腺包膜不完整，并见坏死及明显不均匀强化伴颈部肿大淋巴结是甲状腺间变癌CT较为特征性的表现。
Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease. Methods The CT findings of l0 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed. The patients included 7 females and 3 males. Their age ranged from 25.0 to 78 years with median of 61 years. Multi-slices plain and post contrast CT scans were performed in all patients. Results Unilateral thyroid was involved in 6 patients. Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size. Bilateral thyroid were involved in 2 patients. The maximum diameter of anaplastic thyroid carcinoma ranged from 2. 9-12. 8 cm with mean of （ 4. 5 ± 1.4 ） cm. All lesions demonstrated unclear margins and envelope invasion. The densities of all lesions were heterogeneous and obvious necrosis areas were noted on pre- contrast images. Seven lesions showed varied calcifications, and coarse granular calcifications were found in 5 lesions among them. All lesions showed remarkable heterogenous enhancement on post-contrast CT. The CT value of solid portion of the tumor increased 40 HU after contrast media administration. The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0. 69-0. 82 （0. 76 ± 0. 18 ） and 1.25-1.41 （ 1.33 ±0. 28）on pre and post CT,respectively. Enlarged cervical lymph nodes were found in 6 cases （ 60. 0% ）. It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case. Conclusions Relative larger single thyroid masses with coarse granular calcifications, necrosis, envelope invasion, remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastie thyroid carcinoma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第2期147-151,共5页
Chinese Journal of Radiology
