甲状腺结节CT的鉴别诊断价值(附27例分析)
Value of CT in differential diagnosis of thyroid nodules: A report of 27 cases
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摘要: 目的:观察甲状腺良、恶性结节的CT特征,探讨CT对其鉴别诊断的价值。方法:回顾性对比分析经手术病理证实的甲状腺良性结节13例和恶性结节14例CT平扫片,其中13例甲状腺癌和9例良性结节加做了薄层增强扫描。结果:14例甲状腺癌CT确诊率为92.9%;CT主要表现为:13例癌灶与甲状腺间分界模糊或不整齐,13例CT增强扫描后甲状腺边缘连线中断伴周围脂肪间隙模糊、消失,4例侵犯气管,6例侵犯颈鞘血管,4例侵犯气管-食管旁沟,9例侵犯肌肉或纤维结缔组织,7例同侧颈部淋巴结肿大。13例甲状腺良性结节CT确诊率为84.6%;CT主要表现为:12例病灶与甲状腺间分界清晰、光滑,13例CT增强扫描后甲状腺轮廓完整,12例周围脂肪间隙清晰、存在。27例甲状腺良、恶性结节CT确诊率为88.9%。结论:CT薄层及其增强扫描多可作出良、恶性甲状腺结节的诊断。Abstract: Objective: To study CT characteristic appearances of benign and malignant thyroid nodules,and evaluate the value of CT in differential diagnosis of thyroid nodules.Methods: Thirteen patients with benign thyroid nodule and fourteen patients with malignant thyroid nodules proved by operation and pathology were retrospectively analyzed.All patients were examined by CT plain scan.Among them,13 patients with thyroid carcinoma and 9 patients with benign thyroid nodules underwent thin slice enhanced CT scanning.Results: Thirteen of the 14 patients with thyroid cancer were correctly diagnosed by thyroid CT,and the diagnostic accuracy of CT was 92.9%.In 13 patients with thyroid carcinoma,vague contour of malignant nodules and discontinuing contour of the lesion thyroid outline and vague fatty space around thyroid were shown.Trachea of 4 patients with thyroid carcinoma and carotid sheath of 6 patients and tracheo-asophageal colpus of 4 patients and neck muscles and connective tissue of 9 cases were invaded by malignant lesions.The ipsilateral enlarged lymph nodules were found in 7 patients with thyroid carcinoma.The CT diagnostic accuracy of benign thyroid nodules was 84.6%.In 12 patients with benign thyroid nodule,clear contour and intact thyroid outline were shown and clear fatty space could also be seen.The total CT diagnostic accuracy of all 27 patients with benign and malignant thyroid nodules was 88.9%.Conclusions: Thin slice enhanced CT scan can play an important role in differential diagnosis of thyroid nodules.