结节性甲状腺肿和甲状腺癌的CT鉴别诊断
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摘要
目的探讨采用CT诊断结节性甲状腺肿与甲状腺癌的图像特征对比,总结两者CT的鉴别诊断经验。方法选取本院接诊的54例结节性甲状腺肿与42例甲状腺癌,运用16层螺旋CT对其行平扫和增强扫描,观察两组患者CT诊断图像特征、平扫值与增强扫描值。结果甲状腺癌与结节性甲状腺肿CT图像中,根据CT图像对比来看,甲状腺癌单发占66.67%,结节性甲状腺肿多发占61.11%;甲状腺癌形态不规则占78.57%,结节性甲状腺肿形态规则占98.15%;甲状腺癌边界不清晰占76.19%,结节性甲状腺肿边界清晰占98.15%;甲状腺癌钙化占47.62%,结节性甲状腺肿钙化占12.96%;甲状腺癌晕环占33.33%,结节性甲状腺肿晕环占9.26%;甲状腺癌内部不均匀占88.10%,结节性甲状腺肿内部均匀占40.74%。数量、形态、边界、晕环、钙化、内部均匀性均有明显特征,且对比差异有统计学意义(P<0.05);甲状腺癌与结节性甲状腺肿平扫值、增强扫描值以及两者之间的差值比较,差异均无统计学意义。结论采用CT行结节性甲状腺肿与甲状腺癌诊断,根据其特征能够实现有效鉴别,但仍然需要做好严谨仔细。
Objective To compare the image features of nodular goiter and thyroid carcinoma diagnosed by CT, and summarize the experience of differential diagnosis between them. Methods 54 cases of nodular goiter and 42 cases of thyroid carcinoma were selected and scanned with 16-slice spiral CT. The CT features, plain scan values and enhanced scan values of the two groups were observed. Results According to the CT images of thyroid carcinoma and nodular goiter, 66.67% of them were solitary thyroid carcinoma, 61.11% were nodular goiter, 78.57% were irregular thyroid carcinoma, 98.15% were nodular goiter, 76.19% were unclear thyroid carcinoma, and 61.11% were nodular goiter. The clear margin of the tumor accounted for 98.15%; the calcification of thyroid carcinoma accounted for 47.62%; the calcification of nodular goiter accounted for 12.96%; the halo of thyroid carcinoma accounted for 33.33%; the halo of nodular goiter accounted for 9.26%; the inhomogeneity of thyroid carcinoma accounted for88.10%; the homogeneity of nodular goiter accounted for 40.74%. The number, shape, border, halo, calcification and internal homogeneity of thyroid carcinoma and nodular goiter were significantly different(P<0.05), and there were no significant differences in the plain scan value, enhanced scan value and the difference between them. Conclusion CT diagnosis of nodular goiter and thyroid cancer can be effectively differentiated according to its characteristics, but it still needs to be done carefully.
Objective To compare the image features of nodular goiter and thyroid carcinoma diagnosed by CT, and summarize the experience of differential diagnosis between them. Methods 54 cases of nodular goiter and 42 cases of thyroid carcinoma were selected and scanned with 16-slice spiral CT. The CT features, plain scan values and enhanced scan values of the two groups were observed. Results According to the CT images of thyroid carcinoma and nodular goiter, 66.67% of them were solitary thyroid carcinoma, 61.11% were nodular goiter, 78.57% were irregular thyroid carcinoma, 98.15% were nodular goiter, 76.19% were unclear thyroid carcinoma, and 61.11% were nodular goiter. The clear margin of the tumor accounted for 98.15%; the calcification of thyroid carcinoma accounted for 47.62%; the calcification of nodular goiter accounted for 12.96%; the halo of thyroid carcinoma accounted for 33.33%; the halo of nodular goiter accounted for 9.26%; the inhomogeneity of thyroid carcinoma accounted for88.10%; the homogeneity of nodular goiter accounted for 40.74%. The number, shape, border, halo, calcification and internal homogeneity of thyroid carcinoma and nodular goiter were significantly different(P<0.05), and there were no significant differences in the plain scan value, enhanced scan value and the difference between them. Conclusion CT diagnosis of nodular goiter and thyroid cancer can be effectively differentiated according to its characteristics, but it still needs to be done carefully.
引文
[1]胡振军.CT在结节性甲状腺肿和甲状腺癌中的鉴别价值[J].中国医药指南,2017,15(34):52.
[2]陈广银,陈悦熙.多层螺旋CT诊断结节性甲状腺肿合并甲状腺癌[J].分子影像学杂志,2018,41(2):175-177.
[3]梁坚豪,朱新进,庞力沛,等.CT对结节性甲状腺肿合并甲状腺癌的鉴别诊断作用[J].黑龙江医学,2017,41(6):542-544.
[4]宋习忠,韦素芹.CT与超声对结节性甲状腺肿的诊断价值对比研究[J].中国CT和MRI杂志,2017,15(5):48-50,53.
[5]詹曾云,周沛华,蒋申琦.CT检查在结节性甲状腺肿及甲状腺乳头癌的诊断价值分析[J].中国地方病防治杂志,2017,32(3):281-283.
[6]卢定友,陈望.甲状腺病变的CT诊断和鉴别诊断[J].中外医疗,2016,35(23):188-190.
[7]李敬哲.CT检查在结节性甲状腺肿和甲状腺癌中的鉴别诊断价值分析[J].中外医疗,2016,35(6):166-168.
[8]徐列印,邱维加,何敏丽,等.结节性甲状腺肿合并甲状腺癌的CT诊断[J].临床放射学杂志,2015,34(1):28-31.
[2]陈广银,陈悦熙.多层螺旋CT诊断结节性甲状腺肿合并甲状腺癌[J].分子影像学杂志,2018,41(2):175-177.
[3]梁坚豪,朱新进,庞力沛,等.CT对结节性甲状腺肿合并甲状腺癌的鉴别诊断作用[J].黑龙江医学,2017,41(6):542-544.
[4]宋习忠,韦素芹.CT与超声对结节性甲状腺肿的诊断价值对比研究[J].中国CT和MRI杂志,2017,15(5):48-50,53.
[5]詹曾云,周沛华,蒋申琦.CT检查在结节性甲状腺肿及甲状腺乳头癌的诊断价值分析[J].中国地方病防治杂志,2017,32(3):281-283.
[6]卢定友,陈望.甲状腺病变的CT诊断和鉴别诊断[J].中外医疗,2016,35(23):188-190.
[7]李敬哲.CT检查在结节性甲状腺肿和甲状腺癌中的鉴别诊断价值分析[J].中外医疗,2016,35(6):166-168.
[8]徐列印,邱维加,何敏丽,等.结节性甲状腺肿合并甲状腺癌的CT诊断[J].临床放射学杂志,2015,34(1):28-31.