甲状腺结节钙化的CT表现对鉴别良恶性的价值
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摘要
目的探讨甲状腺结节钙化的CT表现对鉴别良恶性的临床价值。方法回顾性分析492例甲状腺结节的CT表现,比较良恶性结节内钙化在发生率、类型、位置及周围有无增大淋巴结上的差异。结果恶性结节钙化率(65.47%)明显高于良性结节(23.80%);结节中央钙化多见于恶性结节(66.30%),周边钙化多发生于良性结节(63.86%);微钙化、粗钙化和环状钙化在良、恶性结节中分别占33.00%和67.00%,65.67%和34.33%,87.50%和12.50%;伴有钙化的恶性结节周围淋巴结增大(76.06%)的可能性高于没有钙化的结节(23.94%)。结论甲状腺良恶性结节内钙化在发生率、类型、位置及周围有无增大淋巴结上的差异对鉴别结节的良恶性有重要的临床价值。
Objective To evaluate the clinical value of thyroid nodules calcification's CT features in the identification of benign and malignant lesions. Methods The CT features of 492 cases of thyroid nodules were retrospectively analyzed. The incidences of benign and malignant nodular calcification,and differences in the incidence,type,location,and presence or absence of enlarged lymph nodes were compared. Results The calcification rate of malignant nodules(65.47%) was significantly higher than that of benign nodules(23.80%); central calcification of nodules often exist in malignant nodules(63.86%),calcification around the nodules often occurs in benign nodules(66.30%); micro-calcifications,coarse calcifications and ring calcifications accounted for 33.00% and 67.00%,65.67% and 34.33%,87.50% and 12.50%.Malignant nodules with calcification(76.06%) are more likely to be associated with enlarged lymph nodes than without calcification(23.94%). Conclusion The differences of benign and malignant nodular calcification in incidence,type,location and presence or absence of enlarged lymph nodes have important clinical value in the identification of benign and malignant nodules.
Objective To evaluate the clinical value of thyroid nodules calcification's CT features in the identification of benign and malignant lesions. Methods The CT features of 492 cases of thyroid nodules were retrospectively analyzed. The incidences of benign and malignant nodular calcification,and differences in the incidence,type,location,and presence or absence of enlarged lymph nodes were compared. Results The calcification rate of malignant nodules(65.47%) was significantly higher than that of benign nodules(23.80%); central calcification of nodules often exist in malignant nodules(63.86%),calcification around the nodules often occurs in benign nodules(66.30%); micro-calcifications,coarse calcifications and ring calcifications accounted for 33.00% and 67.00%,65.67% and 34.33%,87.50% and 12.50%.Malignant nodules with calcification(76.06%) are more likely to be associated with enlarged lymph nodes than without calcification(23.94%). Conclusion The differences of benign and malignant nodular calcification in incidence,type,location and presence or absence of enlarged lymph nodes have important clinical value in the identification of benign and malignant nodules.
引文
1 Wu CW,Dionigi G,Lee KW,et al.Calcifications in thyroid nodules identified on preoperative computed tomography:patterns and clinical significance[J].Surgery,2012,151:464-470.
2李佳伟,常才,陈敏,等.超声与CT在检测甲状腺结节钙化中的比较[J].中华超声影像学杂志,2016,25:384-387.
3 Lee J,Lee SY,Cha SH,et al.Fine-needle aspiration of thyroid nodules with macrocalcification[J].Thyroid,2013,23:1106-1112.
4 Zhu D,Chen W,Xiang J,et al.Diagnostic value of CT artifacts for solitary coarse calcifications in thyroid nodules[J].Int J Clin Exp Med,2015,8:5800-5805.
5舒艳艳,包凌云,韩志江,等.超声和CT的联合应用在甲状腺滤泡性病变诊断和鉴别诊断中的价值[J].中国临床医学影像杂志,2013,24:543-547,563.
6韩志江,陈文辉,舒艳艳,等.结节性甲状腺肿和甲状腺癌的CT鉴别诊断[J].中国临床医学影像杂志,2011,22:415-417.
7 Liu W,Dong X,Zhu C,et al.Association between computed tomography-detected calcification and thyroid carcinoma[J].Neoplasma,2015,62:641-645.
8 Kim BK,Choi YS,Kwon HJ,et al.Relationship between patterns of calcification in thyroid nodules and histopathologicfindings[J].Endocr J,2013,60:155-160.
9王昌玉,段现良,李小强,等.甲状腺影像报告和数据系统分类在甲状腺微小结节超声检查中的应用[J].中华临床医师杂志(电子版),2016,10:747-750.
10杨海,韩志江,雷志锴,等.CT钙化分型对甲状腺良、恶性结节的诊断价值[J].中国临床医学影像杂志,2015,26:861-863.
11 Oh EM,Chung YS,Song WJ,et al.The pattern and significance of the calcifications of papillary thyroid microcarcinoma presented in preoperative neck ultrasonography[J].Ann Surg Treat Res,2014,86:115-121.
12胡斌,赖旭峰,韩志江,等.CT平扫对甲状腺单纯粗钙化结节良、恶性的预测价值[J].中国临床医学影像杂志,2016,27:774-777.
13 Park YJ,Kim JA,Son EJ,et al.Thyroid nodules with macrocalcification:sonographic findings predictive of malignancy[J].Yonsei Med J,2014,55:339-344.
14韩志江,陈文辉,项晶晶,等.CT环状钙化鉴别甲状腺结节良恶性的价值[J].中华放射学杂志,2014,48:275-278.
15罗德红,石木兰,李复.甲状腺癌淋巴结转移的CT表现[J].中华放射学杂志,2002,36:36-39.
16赵菁.甲状腺癌、甲状腺腺瘤及结节性甲状腺肿CT诊断[J].中华内分泌外科杂志,2014,8:286-289.
2李佳伟,常才,陈敏,等.超声与CT在检测甲状腺结节钙化中的比较[J].中华超声影像学杂志,2016,25:384-387.
3 Lee J,Lee SY,Cha SH,et al.Fine-needle aspiration of thyroid nodules with macrocalcification[J].Thyroid,2013,23:1106-1112.
4 Zhu D,Chen W,Xiang J,et al.Diagnostic value of CT artifacts for solitary coarse calcifications in thyroid nodules[J].Int J Clin Exp Med,2015,8:5800-5805.
5舒艳艳,包凌云,韩志江,等.超声和CT的联合应用在甲状腺滤泡性病变诊断和鉴别诊断中的价值[J].中国临床医学影像杂志,2013,24:543-547,563.
6韩志江,陈文辉,舒艳艳,等.结节性甲状腺肿和甲状腺癌的CT鉴别诊断[J].中国临床医学影像杂志,2011,22:415-417.
7 Liu W,Dong X,Zhu C,et al.Association between computed tomography-detected calcification and thyroid carcinoma[J].Neoplasma,2015,62:641-645.
8 Kim BK,Choi YS,Kwon HJ,et al.Relationship between patterns of calcification in thyroid nodules and histopathologicfindings[J].Endocr J,2013,60:155-160.
9王昌玉,段现良,李小强,等.甲状腺影像报告和数据系统分类在甲状腺微小结节超声检查中的应用[J].中华临床医师杂志(电子版),2016,10:747-750.
10杨海,韩志江,雷志锴,等.CT钙化分型对甲状腺良、恶性结节的诊断价值[J].中国临床医学影像杂志,2015,26:861-863.
11 Oh EM,Chung YS,Song WJ,et al.The pattern and significance of the calcifications of papillary thyroid microcarcinoma presented in preoperative neck ultrasonography[J].Ann Surg Treat Res,2014,86:115-121.
12胡斌,赖旭峰,韩志江,等.CT平扫对甲状腺单纯粗钙化结节良、恶性的预测价值[J].中国临床医学影像杂志,2016,27:774-777.
13 Park YJ,Kim JA,Son EJ,et al.Thyroid nodules with macrocalcification:sonographic findings predictive of malignancy[J].Yonsei Med J,2014,55:339-344.
14韩志江,陈文辉,项晶晶,等.CT环状钙化鉴别甲状腺结节良恶性的价值[J].中华放射学杂志,2014,48:275-278.
15罗德红,石木兰,李复.甲状腺癌淋巴结转移的CT表现[J].中华放射学杂志,2002,36:36-39.
16赵菁.甲状腺癌、甲状腺腺瘤及结节性甲状腺肿CT诊断[J].中华内分泌外科杂志,2014,8:286-289.