论著-头颈部
乳头状甲状腺癌的CT表现与病理对照分析
作者:陈传新1 胡春洪2 马 岩1 赵伟志3
所属单位:1.安徽省马鞍山市中心医院影像中心(安徽 马鞍山 243011) 2.苏州大学附属第一医院影像中心(江苏 苏州 215006) 3.安徽省马鞍山市中心医院病理科(安徽 马鞍山 243011)
PDF摘要
目的探讨乳头状甲状腺癌 (papillary thyroid carcinoma,PTC)的 CT表现与病理学特点,以提高CT诊断正确 率。方法 回顾分析经病理证实的16例PTC 的CT资料, 并与其病理结果进行对比分 析。结果 13例为实性,3例为囊实性,肿 瘤最大长径为0.75-4.6cm,平均3.3cm。 在平扫及增强中,瘤灶密度均低于正常甲 状腺组织。6例(37.5%,6/16)病灶内分布 颗粒状钙化。13例(81.2%,13/16)显示瘤 体边缘模糊及瘤周甲状腺连续性中断。3 例(18.8%,3/16)边界清晰,病理为PTC滤 泡亚型。4例较小瘤灶(微小癌)强化程度 明显低于较大者。结论 PTC具有一定的CT 特异征象, 结合临床特点及病灶内钙化灶 的形态与分布有帮于提高其诊断准确性。
Objective To explore the CT manifestations with corresponding pathologic results of the papillary thyroid carcinomas (PTC) and to improve the CT diagnostic accuracy. Methods The CT findings of 16 PTC patients which confirmed by pathology were retrospectively analyzed and compared with pathological findings. Results In 16 cases,13 cases were solid tumors, and 3 cases contained both solid and cystic components. The maximal diameters of tumors ranged from 0.75cm to 4.6cm (mean 3.3cm). Tumor density was lower than that of normal thyroid tissue both on plain and enhanced CT imaging. 6 cases (37.5%, 6/16) contained scattered round granular calcification inside tumors. The margins of tumors were blurry, and the edge of the thyroid around tumors discontinuous in 13 cases. The margins of tumors were distinct in 3 cases which were follicular subtype of PTC in pathology.The enhanced degree of the smaller tumors was significantly lower than the bigger ones in 4 cases. Conclusion Combined with the distribution and form of calcification and the clinical features, the unique CT characteristics of PTC could improve its iagnostic accuracy.
【关键词】甲状腺;结节性甲状腺肿;乳头状甲状腺癌;x线计算机体 层摄影
【中图分类号】R736.1
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.08.010
前言
甲状腺癌约占全身恶性肿瘤的1%,是最常见的内分泌恶性肿瘤之 一,其中乳头状甲状腺癌最多见[1,2]。许多学者利用影像学方法对甲 状腺病变的良恶性鉴别进行研究,而对单一种类病变的影像研究却很 少。由于甲状腺病变多种多样,不同病理类型的甲状腺病变,其CT表 现也不尽相同,因而,对单一种类病变的影像研究将有利于对其正确 的认识及诊断。本文收集经病理证实的PTC 12例,通过分析其术前CT 表现与病理特点之间的对应关系,旨在探讨CT对其诊断价值。
中国CT和MRI杂志
第13卷, 第 8 期
2015年08月
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