CT增强扫描鉴别甲状腺微小结节良、恶性价值
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摘要
目的:探讨CT增强扫描在甲状腺微小结节良、恶性鉴别诊断中的价值。方法:回顾性分析经组织病理学证实的甲状腺单发微小结节90例(共90枚)的CT资料,按照病理结果分为甲状腺微小乳头状癌(PTMC)45例和微小结节性甲状腺肿(MNG)45例,分析CT平扫和双期增强资料。结果:PTMC和MNG在包膜征、强化方式(中心强化和非中心强化)、边缘中断征、钙化、囊变等方面具有统计学差异(P <0.05),在钙化形态方面无统计学差异(P> 0.05)。结论:平扫均匀低密度、包膜征、中心强化、边缘中断征、钙化提示PTMC的诊断;平扫不均匀低或等密度、无包膜征及边缘中断征、边缘结节样、棘状、环状、新月形强化有助于MNG的诊断。CT增强扫描对甲状腺微小结节灶的良、恶性鉴别诊断有重要价值。
Purpose: To evaluate the value of CT-enhanced scan in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: The CT findings of 90 cases histopathological results confirmed single thyroid micro-nodules(90 in total) were retrospectively reviewed. According to pathological results, the features of the CT plain scan and double-phase enhancement of 45 cases of thyroid micropapillary carcinoma(PTMC) and 45 cases of micronodular goiter(MNG) were analyzed. Results: There was statistical difference in the signs of enveloping,strengthening(centralized and non-enhancing), edge disruption, calcification and cystic changes between PTMC and MNG(P<0.05). No statistical difference in calcification shape was found between the two groups(P>0.05).Conclusion: Features of homogeneous low density, capsule sign, center enhancement, edge discontinuity sign,and calcification conduce to the diagnosis of PTMC. Unevenly low or equal density, non-enveloping and marginal discontinuities, marginal nodular/spiky/annular/crescent strengthening contribute to the diagnosis of MNG. CTenhanced scan is of great value in differential diagnosis of benign and malignant thyroid micro-nodules.
Purpose: To evaluate the value of CT-enhanced scan in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: The CT findings of 90 cases histopathological results confirmed single thyroid micro-nodules(90 in total) were retrospectively reviewed. According to pathological results, the features of the CT plain scan and double-phase enhancement of 45 cases of thyroid micropapillary carcinoma(PTMC) and 45 cases of micronodular goiter(MNG) were analyzed. Results: There was statistical difference in the signs of enveloping,strengthening(centralized and non-enhancing), edge disruption, calcification and cystic changes between PTMC and MNG(P<0.05). No statistical difference in calcification shape was found between the two groups(P>0.05).Conclusion: Features of homogeneous low density, capsule sign, center enhancement, edge discontinuity sign,and calcification conduce to the diagnosis of PTMC. Unevenly low or equal density, non-enveloping and marginal discontinuities, marginal nodular/spiky/annular/crescent strengthening contribute to the diagnosis of MNG. CTenhanced scan is of great value in differential diagnosis of benign and malignant thyroid micro-nodules.
引文
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[2]俞炎平,邝平定,张亮,等.小甲状腺癌的CT表现分析.中华放射学杂志,2010,44:1049-1053.
[3]Lee KH,Kim DW,Baek JW,et al.Comparison of computed tomography features between follicular neoplasm and nodular hyperplasia.Cancer Imaging.2016,16:1-7.
[4]韩志江,陈文辉,周建,等.CT在微小甲状腺癌诊断中的价值.中华放射学杂志,2012,46:135-138.
[5]Cai SZ,Wei L,Jun Y,et al.Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis.Oncology Letters.2016,12:238-242.
[6]骆洪浩,彭玉兰,赵海娜.不同类型的钙化对甲状腺良恶性肿瘤的诊断价值.中国医学计算机成像杂志,2016,22:162-166.
[7]Dong K,Soo J,Tae H,et al,Comparative study of ultrasound and computed tomography for incidentally detecting diffuse thyroid disease.Ultrasound in Med,2014,40:1778-1784.
[8]周翔,王之,彭屹峰,等.甲状腺结节MRI表现特征的应用价值.中国医学计算机成像杂志,2017,23:118-123.
[9]Liu Y,Wu H,Zhou Q,et al.Diagnostic Value of Conventional Ultrasonography Combined with Contrast-Enhanced Ultrasonography in Thyroid Imaging Reporting and Data System(TI-RADS)3 and 4Thyroid Micronodules.MedSci Monit,2016,8:3086-3094.
[10]DAS DK,Psammoma body:a product of dystrophic calcification or of a biologically active process that aims at limiting the growth and spread of tumor.Diagn Cytopathol,2009,37:534-541.
[11]Jenny K,Barton F,Andreia R,et al.Imaging of thyroid carcinoma with CT and MRI:approaches to common scenarios.Cancer Imaging,2013,13:128-139.