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1、2011年11月第8卷第32期·影像与介入·CT在甲状腺结节良恶性鉴别诊断中的作用研究曾艳妮,胡建修,秦涛,刘良进,毕俊英湖北省中山医院放射科,湖北武汉430033[摘要]目的:探讨CT在甲状腺结节良恶性鉴别诊断中的价值。方法:回顾性分析2002年1月~2010年12月经手术及病理组织学检查确诊的105例甲状腺结节患者(136个结节)CT表现,分析良恶性甲状腺结节CT表现及征象差异。结果:良性结节多为多发低密度结节,外形规则,可呈岛状强化结节改变,实性结节中度强化,边缘可见厚薄不均强化环,结节周围及壁光滑锐利,与周围组织分界清楚
2、;恶性结节多为单发低密度结节,密度不均,形状不规则,边缘模糊,内有不规则坏死区,结节周围有强化残圈,与正常组织分界不清,可发生甲状腺周围器官组织浸润和颈部淋巴结转移。良恶性甲状腺结节在结节大小、密度及增强扫描时的密度无明显差异(P>0.05)。与手术病理对照分析表明,良性及恶性甲状腺结节在结节形态、形状、边界、是否有包膜和钙化等方面的差异具有统计学意义(P<0.05),而在是否有壁结节方面的差异无统计学意义(P>0.05)。结论:结节密度、形态、边界、有无包膜及钙化对甲状腺结节良恶性鉴别诊断具有重要意义。[关键词]甲状腺结节;C
3、T;鉴别诊断[中图分类号]R581[文献标识码]B[文章编号]1673-7210(2011)11(b)-093-02StudyofCTvalueinthedifferentialdiagnosisofbenignandmalignantthy-roidnoduleZENGYanni,HUJianxiu,QINTao,LIULiangjin,BIJunyingDepartmentofRadiology,ZhongshanHospitalofHubeiProvince,Wuhan430033,China[Abstract]Objec
4、tive:TostudyCTvalueinthedifferentialdiagnosisofbenignandmalignantthyroidnodule.Methods:CTexpressionof105patientswiththyroidnodules(136nodules)diagnosedbyoperationandhistopathologicalexaminationwereanalyzedretrospectivelyfromJanuary2002andDecember2010.Thedifferencesbe
5、tweenbenignandmalignantthy-roidnoduleswerecompared.Results:Mostbenignnodulesweremultiple,lowdensitynodules,theappearancewasregular,theywereislandandstrengthennoduleschanges,solidnodulesweremoderatestrengthening,thethicknessofstrengtheningringwasunevenontheedge,nodule
6、saroundandwallwassmoothandsharp,therewasacleardemarcationwiththesur-roundingtissue;Moremalignantnodulesweresingle,lowdensitynodules,densitywasuneven,shapewasirregular,edgewasfuzzy,therewasirregularnecroticareainthem,therewasstrengthenincompletecirclearoundthenodules,
7、therewasnotacleardemarcationwiththenormaltissue,infiltratingintoaroundthyroidorgansandcervicallymphnodesmetastasiscouldhappened.Thedifferencesofbenignandmalignantthyroidnodulesindiameter,densityanddensityofenhancedscanwerenostatisticssignificant(P>0.05).Comparedwithp
8、ostoperativepathologicaldiagnosis,thedifferencesofbenignandmalignantthyroidnodulesinshape,boundary,envelope,andcalcificationweresta