多层螺旋CT增强扫描结合三维成像对甲状腺常见病变的诊断
Application of Multilayer Spiral CT Enhancement Scanning Combined with 3D Imaging in Diagnosis of Thyroid Common Disease
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摘要: [摘要]目的 探讨多层螺旋CT增强扫描结合三维成像在甲状腺常见病变方面的诊断价值.方法 回顾性分析云南昆钢医院经手术病理证实的72例甲状腺病变的螺旋CT影像学特点.结果 36例结节性甲状腺肿中呈类圆形均匀或不均匀稍低密度31例,等密度3例,高低密度混杂2例;增强扫描后病变轻度环形强化16例,不强化20例.8例甲状腺腺瘤CT平扫呈类圆形均匀或不均匀稍低密度,增强后8例实性部分中等强化或不均匀明显强化,其中2例见强化壁结节,2例包膜部分明显强化;2例腺瘤囊变伴出血呈等密度无明显强化.甲状腺癌14例,其中7例呈类圆形不均匀稍低混杂密度,3例呈类圆形或不规则形实性肿块,增强后明显不均匀强化,无包膜强化或强化环不完整;颈部淋巴结转移2例.12例结节性甲状腺肿伴滤泡性腺瘤或局部腺瘤样增生与4例结节性甲状腺肿伴微小乳头状癌表现类似,CT平扫均表现多中心类圆形不均匀低、稍低混杂密度,增强后病变区局部不均匀轻—中度强化或伴有强化结节.结论 多排螺旋CT扫描结合三维成像可反映甲状腺病变的形态、大小、密度、数目及与周围组织结构的关系、颈部淋巴结的情况,对甲状腺病变良恶性鉴别方面有一定的诊断价值.
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关键词:
- [关键词]甲状腺疾病 /
- 多层螺旋CT /
- 增强扫描 /
- 三维成像
Abstract: [Abstract]Objective To investigate the value of multi-layer spiral CT enhancement scanning combined with 3 d imaging in diagnosis of common thyroid diseases.Method We retrospectively analysed the spiral CT imaging characteristics of 72 cases of thyroid lesions confirmed by surgery and pathology.Results In 36 cases of nodular goiter,31 cases showed circular uniform or non-uniform slightly low density,3 cases showed equal density,2 cases showed mixed high and low density. 16 cases showed mild circle enhancement and 20 cases showed non-enhancement after enhancement scan lesions. 8 cases of thyroid adenoma showed circular uniform or non-uniform slightly low density after CT plain scan,and showed middle enforcement or uneven enforcement in solid after enforcement scan,among them, 2 cases showed enforced wall nodules,and 2 cases showed obviously enforced envelope,2 cases of cystic degeneration of adenoma and bleeding showed equal density without enforcement.In 14 cases of thyroid carcinoma,7 cases showed circular uneven slightly lower hybrid density,3 cases showed round like or irregular solid mass,and showed obviously uneven enforcement,no no envelope reinforcement or non-complete enforcement ring,2 cases showed neck lymph node metastasis.12 cases of nodular goiter with follicular adenoma or local adenomatoid hyperplasia and 4 cases of nodular goiter with tiny papillary carcinoma had similar performance,CT plain scan showed multi center circular uneven low,slightly lower hybrid density and showed local uneven light - moderate enforced nodules in the lesion area after enforcement scan. Conclusion Multi-slice spiral CT scanning combined with 3 d imaging can reflect the form,size,density,number of thyroid lesions,their relationship with the surrounding tissue structure,and lymph nodes in the neck,so has diagnostic value in identification of benign and malignant thyroid lesions.
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