赖旭峰,舒艳艳,韩志江.CT在甲状腺滤泡性结节病变诊断和鉴别诊断中的价值[J].肿瘤学杂志,2013,19(6):470-475.
CT在甲状腺滤泡性结节病变诊断和鉴别诊断中的价值
Value of Computed Tomography in the Diagnosis and Differential Diagnosis for Thyroid Follicular Nodular Lesions
投稿时间:2013-03-14  
DOI:10.11735/j.issn.1671-170X.2013.06.B013
中文关键词:  甲状腺结节  甲状腺病变  体层摄影术,X线计算机  诊断  鉴别诊断
英文关键词:thyroid nodule  thyroid lesions  X-ray,computed tomography  diagnosis  differential diagnosis
基金项目:2012杭州市卫生科技计划项目(2012A020)
作者单位
赖旭峰 杭州市第一人民医院 
舒艳艳 杭州萧山区第一人民医院 
韩志江 杭州市第一人民医院 
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中文摘要:
      摘 要:[目的] 探讨CT在甲状腺滤泡性结节病变诊断和鉴别诊断中的价值。[方法] 搜集经病理证实的122例135枚甲状腺滤泡性结节病变的CT资料,其中包括92例105枚腺瘤性甲状腺肿(ANG),17例17枚腺瘤(FA),13例13枚滤泡细胞癌(FC)。分别对ANG与FA、ANG和FA(ANG-FA)与FC在病变形态、平扫密度、强化程度、增强后边界、坏死及钙化状态进行统计分析,并对ANG-FA与FC的环状钙化进行分析。[结果] 平扫密度在ANG和FA诊断中具有统计学差异(P<0.05),形态、强化程度、增强后边界及环状钙化在ANG-FA和FC间具有统计学差异(P<0.05),而病变强化程度、增强后边界、坏死、钙化在ANG与FA诊断中无统计学差异(P>0.05),病变平扫密度、坏死、钙化状态在ANG-FA与FC组中无统计学差异(P>0.05)。[结论] CT在滤泡性结节病变的诊断中具有重要价值,平扫密度均匀倾向于FA的诊断,强化程度高于周围甲状腺有助于ANG或FA的诊断,而形态不规则、强化程度低于周围甲状腺、增强后边界较平扫清晰及环状钙化有助于FC的诊断。
英文摘要:
      Abstract:[Purpose] To investigate the value of computed tomography(CT) in the diagnosis and differential diagnosis for thyroid follicular nodular lesions. [Methods] CT findings of 135 lesions in 122 patients with thyroid follicular nodular lesions pathologically proven were analyzed retrospectively. Among them, 105 lesions in 92 patients with adenomatoid noduler goiter(ANG),17 lesions in 17 patients with follicular adenoma(FA), and 13 lesions in 13 patients with follicular carcinoma(FC) were included. The shape of lesions, density in plain scan, degree of enchancement, lesions boundaries after contrast enchancement, necrosis and calcification were compared between ANG and FA;ANG-FA and FC; as well as ring calcifications was compared between ANG-FA and FC.[Results] ANG and FA had significant difference in density of plain scan(P<0.05), while no significant difference in the degree of enchancement, lesion boundaries after contrast enchancement, necrosis and calcification was observed(P>0.05). Shape of lesions, degree of enchancement, lesion boundaries after contrast enchancement and ring calcification were significantly different between ANG-FA and FC(P<0.05), while no statistical significance in the density in plain scan, necrosis and calcification was observed(P>0.05). [Conclusion] CT plays an important role in the diagnosis and differential diagnosis for thyroid follicular nodular lesions. Homogeneity density with plain scan had a trend toward the diagnosis for FA; Higher enhancement with plain scan in thyroid tissue than that in thyroid around tissue toward the diagnosis of ANG or FA; while irregular shape, lower enhancement in thyroid tissue than that in thyroid around tissue, clearer image than plain scan after contrast enchancement and ring calcification are helpful for the diagnosis of FC.
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