论著-头颈部
超声与CT在识别甲状腺结节钙化的一致性与差异性分析
作者:董凌云1 陈 娟2 袁生武3
所属单位:1.驻马店市第一人民医院超声科(河南 驻马店 463000) 2.河南省人民医院超声科(河南 郑州 450000) 3.郑州大学第五附属医院放射介入科(河南 郑州 450000)
PDF摘要
目的探讨超声与CT在识别甲 状腺结节钙化的一致性与差异性。方 法 分析我院2017年1月-2018年1月收治 的186例甲状腺结节钙化患者超声及16 排螺旋CT图像资料,对比超声与CT对甲 状腺结节钙化的检出率。结果 186例 患者共甲状腺结节385枚,其中良性结 节64.16%,恶性结节35.84%。病理类 型:结节性甲状腺肿瘤79.03%,甲状 腺炎20.97%。恶性结节中甲状腺乳头 状癌25.97%、滤泡状癌3.90%、髓样癌 3.38%、未分化癌2.60%。CT诊断符合率 显著高于超声(P<0.05),误诊漏诊率显 著低于超声(P<0.05)。CT囊变、侵袭包 膜、边界清晰、晕环、钙化、淋巴结肿 大检出率显著高于对照组(P<0.05)。超 声特征:21枚钙化甲状腺结节中细钙化 57.14%、粗钙38.10%、孤立钙化9.52%、 环形钙化4.72%。细钙化甲状腺结节直 径0-2mm,平均直径(1.25±0.14)mm,呈 砂粒体。粗钙化直径3-8mm,平均直径 (5.59±1.42)mm,见强回声。CT特征: 良性甲状腺钙化边缘光滑,恶性病变钙 化边缘欠缺。53枚钙化中45.28%伴结节 密度,呈细颗粒样。结论 砂粒体是超 声与CT识别甲状腺结节钙化的一致性特 征,二者联合诊断价值更高。
Objective To investigate the consistency and difference between ultrasound and CT in identifying calcification of thyroid nodules. Methods In this study, the imaging data of 186 patients with calcification of thyroid nodules admitted to our hospital from January 2017 to January 2018 who received ultrasound and 16-slice spiral CT were analyzed. Results Among the 186 patients, 385 lesions were confirmed by pathology, including 64.16% of benign nodules and 35.84% of malignant nodules. Pathological types: 79.03% were nodular thyroid tumors, 20.97% were thyroiditis. The malignant nodules were dominated by papillary thyroid carcinoma, follicular carcinoma, medullary carcinoma, and undifferentiated carcinoma, accounted for 25.97%, 3.90%, 3.38%, 2.60%, respectively. The CT had higher consistency rate as well as lower misdiagnosis rate than those of the ultrasound (P<0.05). The detection rate of thyroid nodules cystic change, invasive capsule, lesion borders, halo ring, calcification, enlarged lymph nodes was higher in CT than the ultrasound examination (P<0.05). Ultrasound features: The detection rate of the microcalcifcation, coarse calcification, crescent-like calcification and annular-like calcification among 21 cases of thyroid nodular calcification were 57.14%, 38.10%, 9.52% and 4.72% respectively. The diameter of microcalcifcation was 0~2mm with an average of (1.25±0.14) mm, which was in psammoma body. The diameter of coarse calcification was 3~8mm, with an average diameter of (5.59±1.42) mm, which had strong echo. CT features: The margins were smooth among the benign thyroid calcification and malignant lesions. Of the 53 calcifications, 45.28% were associated with nodule density, which were fine-grained. Conclusion The psammoma body is a consistent feature of ultrasound and CT in identifying calcification of thyroid nodules, and the combined detection has a higher diagnosis value.
【关键词】超声;CT;甲状腺结节钙化; 砂粒体
【中图分类号】R581;R445
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.11.013
前言
甲状腺结节是甲状腺常见疾病,其中10%[1]为恶性甲状腺结节。甲 状腺结节的良恶性决定临床该选用何种措施治疗[2]。故术前诊断甲状 腺结节性质尤为重要。影像学是诊断甲状腺结节的重要方法,甲状腺 结节钙化形态、大小等影响影像学诊断结果。选择正确的影像学方法 识别甲状腺结节钙化[3],有利于提高诊断正确性。本文回顾分析我院 2017年1月-2018年1月收治的甲状腺结节病变患者,应用超声及CT诊 断,现将研究结果汇报如下。
中国CT和MRI杂志
第16卷, 第 11 期
2018年11月
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