摘要
目的探讨甲状腺结节患者的 MRI诊断效果。方法 回顾性分析我院 2015年1月-2017年1月收治的120例甲状 腺结节患者临床资料及MR表现特征。结 果 120例患者MRI共诊断出159枚甲状腺 结节,其中80枚良性结节,79枚恶性结 节,病理检出161枚甲状腺结节,其中 良性结节89枚,恶性结节72枚。良性结 节形态、边界、结节是否伴囊变、增强 扫描强化方式、是否伴有甲状腺弥漫性 肿大等情况与恶性结节比较差异有统计 学意义(P<0.05),结节数目比较差异无 统计学意义(P<0.05)。29例甲状腺癌, 检出率为24.17%。其中,左叶15例、 右叶13例、峡部2例,结节短径0.61- 5.94cm,平均短径(0.48±0.10)cm。同 侧淋巴结转移19例,双侧淋巴结转移10 例,侵犯气管7例,局部皮肤软组织侵犯 14例。T1WI高信号者13例、T2WI高信号 者5例,T1WI低或等信号者4例、T2WI低 或等信号者7例。良性结节中,右叶54 枚,左叶26枚,结节短径1.20-5.41cm, 平均短径(3.59±0.18)cm。T1WI高或者 54例、T2WI高信号者15例,T1WI等信号 者21例、T2WI等信号者9例。结论 MRI能 有效鉴别甲状腺良恶性结节,恶性甲状 腺结节多边缘不规则、界限模糊、伴囊 变、增强扫描强化不均匀、伴有甲状腺 弥漫性肿、有侵犯倾向。而良性结节轮 廓边缘清晰,MRI信号为等信号,且良性 肿瘤多表现为转移。
Objective To investigate the MRI diagnostic effect of thyroid nodule. Methods The clinical data and MR imagings of 120 patients with thyroid nodules admitted in our hospital from January 2015 to January 2017 were analyzed retrospectively. Results MRI diagnoed 159 thyroid nodules among 120 patients, including 80 cases of benign nodules and 79 cases of malignant nodules. Pathology detected 161 thyroid nodules, of which 89 were benign nodules and 72 were malignant nodules. The nodule morphology, boundary, cystic degeneration, enhancement schedule, and diffuse thyroid enlargement of benign nodules and malignant nodules were significantly different (P<0.05), no difference was found in the nodules number (P<0.05). Of 29 cases of thyroid cancer, the detection rate was 24.17%. Among them, 15 cases located at left lobe, 13 cases located at right lobe, and 2 cases located at isthmus. The short diameter of nodules ranged from 0.61 to 5.94 cm with an average of (0.48±0.10) cm. There were 19 cases of ipsilateral lymph node metastases, 10 cases of bilateral lymph node metastases, 7 cases of the trachea violations, and 14 cases of local skin and soft tissue violations. There were 13 cases with T1WI high signal and 5 cases with T2WI high signal, 4 cases with low or equal signal on T1WI, and 7 cases with low or equal signal on T2WI. Among the benign nodules, there were 54 right leaves and 26 left leaves. The short diameter of the nodules ranged from 1.20 to 5.41 cm with an average of (3.59±0.18) cm. There were 15 cases with high T1WI or 15 cases with high signal on T2WI, 21 cases with signal on T1WI, and 9 cases with signal on T2WI. Conclusion MRI can effectively distinguish the benign and malignant thyroid nodules. Malignant thyroid nodules mostly manifest as irregular nodule margins, blurred boundaries, nodular cystic changes, inconsistent enhancement of enhanced scans, and tendency to diffuse diffuse thyroid lesions. The benign nodule is characterized with clear edges and equal MRI signals.
【关键词】甲状腺结节;良恶性;MRI; 鉴别
【中图分类号】R445.2 R736.1
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.10.003
前言
甲状腺上皮小体呈扁平状、椭圆形,部分可为蚕豆形[1]、卵形、 香肠形。甲状腺结节是预后较为乐观的恶性肿瘤之一。甲状腺乳头状 癌占全部甲状腺癌的85%[2],近些年来呈上升趋势,其中单侧甲状腺癌 最为常见,双侧甲状腺癌较少,多病灶癌最少。B超、CT、MRI是诊断 甲状腺结节主要方法,其中MRI软组织分辨率较高,扫描范围较广,视 野盲区较少,在甲状腺疾病的诊断具有巨大潜力。本文回顾性分析我 院2015年1月-2017年1月收治的甲状腺结节患者,应用MRI诊断,现将 研究结果汇报如下。
中国CT和MRI杂志
第16卷, 第 10 期
2018年10月
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