结节性甲状腺肿多层螺旋CT诊断及鉴别诊断
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摘要
目的:探讨结节性甲状腺肿(GN)的多层螺旋CT(MSCT)表现,以提高对GN诊断的准确率。方法:回顾性分析经临床术后病理证实25例GN患者的MSCT表现,所有病例均进行CT平扫及双期增强扫描。结果:本组病例中16例多发,9例单发,最大病灶直径在0.7~6.9cm之间,16例直径在2.0~4.0cm之间。25例GN病灶中,类圆形22例,不规则3例;境界清楚19例,境界模糊6例。平扫病灶呈等、低密度(与甲状腺实质比较),CT值在28~84 HU之间,伴坏死、囊变12例,伴钙化13例,大部分呈边缘点、结节状钙化。双期增强扫描病灶以中度不均匀强化为主,呈向心充填性强化,强化范围在57~178HU之间。结论:GN的MSCT表现具有一定的特征性,认识这些特点有助于GN的诊断与鉴别诊断。
Objective:To investigate the multi-slice spiral CT(MSCT)manifestations of nodular goiter(GN),to further improve the accuracy of the diagnosis.Methods:The MSCT findings were analyzed retrospectively in 25 cases of GN confirmed by pathology.All cases were performed CT plain scan and dual phase enhanced scan.Results:In this group,16 cases were multiple,9 cases were single,the maximum lesion diameter was from 0.7 cm to 6.9 cm,and 16 cases were between 2.0 and 4.0 cm.Of the 25 cases,22 were round and 3 were irregular,19 were clear,and 6 were vague.The lesions were equal and low density(compared with the parenchyma of the thyroid gland).The CT value was between 28 HU and 84 HU,with necrosis and cystic degeneration in 12 cases,with calcification in 13 cases.Most of them were Punctate and nodular calcification on the edge.The dual phases of enhanced scan showed moderate inhomogeneous enhancement,with a centripetal filling enhancement,and the enhancement range was between 57 and 178 HU.Conclusion:The MSCT performance of GN has a certain characteristic,which can help GN diagnosis and differential diagnosis.
Objective:To investigate the multi-slice spiral CT(MSCT)manifestations of nodular goiter(GN),to further improve the accuracy of the diagnosis.Methods:The MSCT findings were analyzed retrospectively in 25 cases of GN confirmed by pathology.All cases were performed CT plain scan and dual phase enhanced scan.Results:In this group,16 cases were multiple,9 cases were single,the maximum lesion diameter was from 0.7 cm to 6.9 cm,and 16 cases were between 2.0 and 4.0 cm.Of the 25 cases,22 were round and 3 were irregular,19 were clear,and 6 were vague.The lesions were equal and low density(compared with the parenchyma of the thyroid gland).The CT value was between 28 HU and 84 HU,with necrosis and cystic degeneration in 12 cases,with calcification in 13 cases.Most of them were Punctate and nodular calcification on the edge.The dual phases of enhanced scan showed moderate inhomogeneous enhancement,with a centripetal filling enhancement,and the enhancement range was between 57 and 178 HU.Conclusion:The MSCT performance of GN has a certain characteristic,which can help GN diagnosis and differential diagnosis.
引文
[1]邹新农,朱海贤,王心涛,等.结节性甲状腺肿的CT诊断[J].中国医学计算机成像杂志,2005,11(2):91-94.
[2]田春艳,谢敬霞.结节性甲状腺肿的CT诊断[J].中国医学影像技术,2001,17(10):964-965.
[3]Blanco CC,Garciadiaz JD,Maqueda VE,et al.Diagnostic efficacy of fine needle aspiration biopsy in patients with thyroid nodular disease.Analysis of 510cases[J].Revista Clínica Espanola,2005,205(8):374-378.
[4]王崇稳,陈孝柏,杨磊,等.胸腔入口区结节性甲状腺肿的螺旋CT诊断与鉴别诊断[J].CT理论与应用研究,2009,18(4):96-101.
[5]白人驹,张雪林,孟俊非,等.医学影像诊断学[M].3版.北京:人民卫生出版社,2011:172.
[6]许建生,姚沛旭,陈少龙,等.甲状腺单发囊性病变48例CT分析[J].实用放射学杂志,2007,23(1):33-35.
[7]叶晖,赵代伟,王南鹏,等.血清TSH浓度与结节性甲状腺肿癌变关系的临床研究[J].贵州医药,2010,34(7):596-598.
[8]田春艳,谢敬霞.结节性甲状腺肿的CT诊断[J].中国医学影像技术,2001,17(10):964-966.
[9]冯光健,蔡小涛.多层螺旋CT对结节性甲状腺肿的诊断价值[J].医学影像学杂志,2015,25(3):422-424.
[10]谢榜昆,关玉宝,袁小平,等.甲状腺癌的CT表现与病理相关性研究[J].癌症,2003,22:192.
[11]张建伟,刘海泉,杨建伟,等.CT对甲状腺肿瘤的鉴别诊断价值[J].实用放射学杂志,2005,21(11):1154-1156.
[12]江明祥,邵国良,陈波.原发性甲状腺淋巴瘤的CT表现分析[J].影像诊断与介入放射学,2014,32(2):151-155.
[2]田春艳,谢敬霞.结节性甲状腺肿的CT诊断[J].中国医学影像技术,2001,17(10):964-965.
[3]Blanco CC,Garciadiaz JD,Maqueda VE,et al.Diagnostic efficacy of fine needle aspiration biopsy in patients with thyroid nodular disease.Analysis of 510cases[J].Revista Clínica Espanola,2005,205(8):374-378.
[4]王崇稳,陈孝柏,杨磊,等.胸腔入口区结节性甲状腺肿的螺旋CT诊断与鉴别诊断[J].CT理论与应用研究,2009,18(4):96-101.
[5]白人驹,张雪林,孟俊非,等.医学影像诊断学[M].3版.北京:人民卫生出版社,2011:172.
[6]许建生,姚沛旭,陈少龙,等.甲状腺单发囊性病变48例CT分析[J].实用放射学杂志,2007,23(1):33-35.
[7]叶晖,赵代伟,王南鹏,等.血清TSH浓度与结节性甲状腺肿癌变关系的临床研究[J].贵州医药,2010,34(7):596-598.
[8]田春艳,谢敬霞.结节性甲状腺肿的CT诊断[J].中国医学影像技术,2001,17(10):964-966.
[9]冯光健,蔡小涛.多层螺旋CT对结节性甲状腺肿的诊断价值[J].医学影像学杂志,2015,25(3):422-424.
[10]谢榜昆,关玉宝,袁小平,等.甲状腺癌的CT表现与病理相关性研究[J].癌症,2003,22:192.
[11]张建伟,刘海泉,杨建伟,等.CT对甲状腺肿瘤的鉴别诊断价值[J].实用放射学杂志,2005,21(11):1154-1156.
[12]江明祥,邵国良,陈波.原发性甲状腺淋巴瘤的CT表现分析[J].影像诊断与介入放射学,2014,32(2):151-155.