增强CT扫描在甲状腺肿瘤鉴别诊断中的价值

目的探讨增强CT扫描在甲状腺肿瘤鉴别诊断中的价值及重要性.方法回顾性分析经手术及病理证实的27例甲状腺肿瘤的术前CT增强前后表现,其中甲状腺腺瘤18例,甲状腺乳头状癌9例.结果增强扫描18例腺瘤中,12例囊性腺瘤有完整性强化环,6例实体腺瘤瘤内岛形强化结节.9例乳头状癌中均无完整强化环,其中4例瘤壁强化结节.9例乳头状癌中7例瘤内有钙化(呈斑点状、细颗粒状或二者混合状),4例甲状腺周围器官侵犯.结论甲状腺肿瘤必须强调增强扫描才能显示甲状腺肿瘤的病理特征,对鉴别诊断具有重要价值.甲状腺周围器官侵犯是诊断甲状腺癌的肯定征象.瘤壁乳头状强化结节和瘤内斑点状、颗粒状钙化是甲状腺乳头状癌的可靠诊断征象.瘤周完整性强化环、瘤壁光滑锐利是良性腺瘤的征象.

Enhanced CT Scan in Differential Diagnosis of Thyroid Neoplasm

Objective To evaluate the value of enhanced CT scan in differential diagnosis of thyroid neoplasm.Methods 27 cases of thyroid neoplasm including 18 cases of thyroid adenoma and 9 cases of thyroid papillary carcinoma proved by operation and pathology were retrospectively analyzed.Results In 18 cases of thyroid adenoma,there were 12 cases with well defined enhanced ring and 6 cases with enhanced nodule in adenoma.In 9 cases of thyroid papillary carcinoma,there were no complete enhanced ring on the wall,and 4 cases with enhanced nodule on the wall,there were 7 cases with fine granular or plague like calcifications and 4 cases with sign of surrounding structures involved.Conclusion In CT diagnosis of thyroid neoplasm,enhanced scan is necessary for characterization of the tumors.Invasion of surrounding structures is a characteristic sign of malignancy.Nodules enhancement of the tumor wall accompanied with granular calcification is the signs of thyroid papillary carcinoma,tumor sharp wall is the sign of adenoma.