目的 探究多层螺旋CT(MSCT)在 甲状腺髓样癌术后索拉非尼应用治疗期间 中应用价值。方法 回顾性分析2015年至 2016年于我院诊治的38例甲状腺髓样癌术 后患者的临床资料。所有患者均因术后出 现进行性气急而给予索拉非尼治疗。分析 患者的病理学资料、比较患者治疗前后 降钙素(CT)及癌胚抗原(CEA)阳性率；通 过分析患者用药前、用药8周后、用药32 周后的MSCT图像并计算目标病灶最大径 线及其缩小率，进而评估MSCT在甲状腺 髓样癌术后索拉非尼应用治疗期间中应 用价值。结果 病理学结果显示，治疗前 所有患者癌组织均有CT及CEA弥漫(+)但 CK19、Tg表达不定；用药8周后患者癌组 织内降钙素CT和CEA阳性率15.79%(6例) 和26.32%(10例)＜用药4周后68.42%(26 例)和73.68%(28例)＜用药前100%(38例) 和100%(38例)，差异均有统计学意义(P ＜0.05)。MSCT检查结果显示：用药前 MSCT图像显示患者的淋巴结转移情况与病 理学结果比较无统计学意义(P＞0.05)； 用药8周后病灶形态、边界及密度等情 况均得到改善，有65.79%(25例)患者病 灶边界清楚、密度较均匀高于用药前13 例(34.21%)规则、14例(36.84%)清楚(P ＜0.05)；用药8周后患者目标病灶最大径 线＜用药4周后＜用药前，用药8周后患 者肿瘤进一步缩小但其缩小率＜用药4周 后，且各用药时间点比较差异均有统计学 意义(P＜0.05)。结论 MSCT图像显示， MTC术后患者应用索拉非尼治疗后病灶形 态、边界及密度等情况均得到改善，目标 病灶最大径线缩短、瘤体缩小；表明MSCT 对评价索拉非尼治疗MTC术后患者的临床 疗效具有一定的指导意义。

Objective To explore application effect of multi slice spiral CT in medullary thyroid carcinoma postoperative sorafenib applied therapy. Methods A retrospective analysis of clinical data was carried out in 38 medullary thyroid carcinoma postoperative patients treated in our hospital from 2015 to 2016. All patients underwent sorafenib treatment due to postoperative progressive flustered and exasperated. Pathological data of patients were analyzed, thyrocalcitonin (CT) and positive rate of carcinoembryonic antigen (CEA) before and after the treatment were compared. MSCT images of patients before medication, after 8 weeks of medication, 32 weeks after medication were analyzed, target lesion maximum diameter and its minification were counted to estimate application effect of MSCT in medullary thyroid carcinoma postoperative sorafenib applied therapy. Results Pathological results showed that cancer tissues of patients before the treatment had CT and CEA suffuse(+), but CK19, Tg expression were indefinite; thyrocalcitonin CT and positive rate of CEA in cancer tissues of patients 15.79% (6 cases) and 26.32% (10 cases) after 8 weeks of medication < 68.42% (26 cases) and 73.68% (28 cases) after 4 weeks of medication < 100% (38 cases) and 100% (38 cases) before medication, which were significantly different (P<0.05). MSCT examination results showed that there was no significant difference in lymph node metastasis and pathological results showed in MSCT images before medication (P>0.05), lesion morphology, boundary, density and others after 8 weeks of medication were improved, 65.79% (25cases) patients had clear margin of lesions, density was well-distributed, which were higher than 13 cases (34.21%) regular, 14 cases (36.84%) clear (P<0.05), target lesion maximum diameter of patients after 8 weeks of medication < after 4 weeks of medication < before medication, tumors of patients were further narrowed after 8 weeks of medication, but its minification < after 4 weeks of medication, there was a significant difference at different time points (P<0.05). Conclusion MSCT images show that after application of sorafenib treatment in MTC postoperative patients, lesion morphology, boundary, density and others are improved, target lesion maximum diameter is shortened, tumors are reduced; which indicates MSCT has certain guiding significance for the evaluation of clinical effect of sorafenib treatment in MTC postoperative patients.