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MSCT对结节性甲状 腺肿的诊断价值

作者:李 健 蒋华东 顾庆春 薛春华 范晔辉

所属单位:江苏省启东市人民医院影像科 (江苏 启东 226200)

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摘要

目的 探讨MSCT对结节性甲状腺 肿(Nodular goiter,NG)的诊断价值。方 法 回顾性分析38例经手术及病理证实的 NG病例的MSCT表现。结果 病灶多发22 例,单发16例;平扫为低密度或略低密度 29例,等或略高密度7例,完全高密度钙 化2例;增强扫描病灶边界均清晰显示, 无一例超出甲状腺包膜;气管受压5例; 25例可见不同程度囊变,增强扫描囊变 区无强化,10例周边可见环形强化,2例 见壁结节;10例见钙化;8例病灶见间隔 线;颈部淋巴结均未见肿大;非囊变区增 强后见不均匀强化,强化程度不等。 结 论 MSCT能清晰显示病变的内部结构、边 缘、强化特点及与周围结构的关系,并具 有一定特征性,对NG的术前诊断具有重要 价值。

Objective To evaluate clinical contribution of MSCT in diagnosing nodular goiter (NG). Methods a total of 38 NG cases confirmed by postoperative pathology were enrolled. Performances of MSCT in each case were retrospectively analyzed. Results 22 cases presented multiple lesions, while 16 cases were solitary lesions. In plain scan, 29 cases showed low density or slight low density, 7 cases presented equal or slight high density and 2 cases were totally high density calcification. After enhancement, boundary of every lesion of each case could be clearly illustrated, and no case exceeded envelop. However, 5 cases showed tracheal compression. Cyst formation was seen in 25 cases, no enhancement was demonstrated, whereas circular enhancement was presented in peripheral. Mural nodules were seen in 2 cases, calcifications were demonstrated in 10 cases, and septal lines were identified in 8 cases. All the cervical lymph nodes were negative. Noncystic area showed inhomogeneous enhancement with different degree after contrast medium. Conclusion Inner structure, edge, feature of enhancement, and relationship with surroundings were clearly demonstrated by MSCT, which guarantee its clinical value in pre-operative evaluation on thyroid nodules.

【关键词】甲状腺肿;结节性;体层摄影 术,X线计算机

【中图分类号】R581.3;R445.3

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.11.016

前言

随着医学影像学的不断发展及人们健康意识的不断增强,甲状腺 结节的检出率明显增高。在所有甲状腺结节病变中,NG的发生率占 44.93%[1]。本文回顾性分析2012年8月~2016年2月间经手术及病理证 实的38例结节性甲状腺肿患者资料,重点分析其MSCT表现,探讨MSCT 对结节性甲状腺肿的诊断价值。