中国CT和MRI杂志
中國CT和MRI雜誌
중국CT화MRI잡지
CHINESE JOURNAL OF CT AND MRI
2014年
8期
34-37
,共4页
甲状腺结节样病变%多排螺旋CT%鉴别诊断
甲狀腺結節樣病變%多排螺鏇CT%鑒彆診斷
갑상선결절양병변%다배라선CT%감별진단
Thyroid Nodular Lesions%Multi-detector Row Spiral CT%Differential Diagnosis
目的：探讨甲状腺结节样病变良恶性的MDCT鉴别诊断价值。方法对36例经手术病理及穿刺活检证实的甲状腺结节样病变患者的临床及MDCT资料进行回顾性分析。结果恶性病变16例，良性病变20例。二者性别、年龄无统计学差异(P＞0.05)；恶性者多表现为单发结节，形态不规则，边界不清楚，甲状腺包膜不完整，邻近结构的侵犯和颈部淋巴结的增大，与良性者比较具有统计学差异(P＜0.05)；病灶钙化率无显著性差异(P＞0.05)，但钙化的形态及部位差异具有统计学意义(P＜0.05)。病灶形态不规则、边界不清晰、甲状腺包膜不完整、病灶内细颗粒状钙化、邻近结构侵犯和颈部淋巴结增大对恶性诊断的阳性预测值分别为68.8%、70.6%、75.0%、77.8%、100.0%、76.9%，敏感性分别为68.8%、75.0%、75.0%、43.8%、56.3%、62.5%，特异性分别为75.0%、75.0%、80.0%、90.0%、100.0%、85.0%。结论 MDCT能全面观察甲状腺结节样病变的大小、形态、数量、边缘、强化、钙化、有无囊变、与邻近结构的关系及颈部淋巴结情等况，对这些征象进行综合分析，对良恶性的鉴别具有重要价值。
目的：探討甲狀腺結節樣病變良噁性的MDCT鑒彆診斷價值。方法對36例經手術病理及穿刺活檢證實的甲狀腺結節樣病變患者的臨床及MDCT資料進行迴顧性分析。結果噁性病變16例，良性病變20例。二者性彆、年齡無統計學差異(P＞0.05)；噁性者多錶現為單髮結節，形態不規則，邊界不清楚，甲狀腺包膜不完整，鄰近結構的侵犯和頸部淋巴結的增大，與良性者比較具有統計學差異(P＜0.05)；病竈鈣化率無顯著性差異(P＞0.05)，但鈣化的形態及部位差異具有統計學意義(P＜0.05)。病竈形態不規則、邊界不清晰、甲狀腺包膜不完整、病竈內細顆粒狀鈣化、鄰近結構侵犯和頸部淋巴結增大對噁性診斷的暘性預測值分彆為68.8%、70.6%、75.0%、77.8%、100.0%、76.9%，敏感性分彆為68.8%、75.0%、75.0%、43.8%、56.3%、62.5%，特異性分彆為75.0%、75.0%、80.0%、90.0%、100.0%、85.0%。結論 MDCT能全麵觀察甲狀腺結節樣病變的大小、形態、數量、邊緣、彊化、鈣化、有無囊變、與鄰近結構的關繫及頸部淋巴結情等況，對這些徵象進行綜閤分析，對良噁性的鑒彆具有重要價值。
목적：탐토갑상선결절양병변량악성적MDCT감별진단개치。방법대36례경수술병리급천자활검증실적갑상선결절양병변환자적림상급MDCT자료진행회고성분석。결과악성병변16례，량성병변20례。이자성별、년령무통계학차이(P＞0.05)；악성자다표현위단발결절，형태불규칙，변계불청초，갑상선포막불완정，린근결구적침범화경부림파결적증대，여량성자비교구유통계학차이(P＜0.05)；병조개화솔무현저성차이(P＞0.05)，단개화적형태급부위차이구유통계학의의(P＜0.05)。병조형태불규칙、변계불청석、갑상선포막불완정、병조내세과립상개화、린근결구침범화경부림파결증대대악성진단적양성예측치분별위68.8%、70.6%、75.0%、77.8%、100.0%、76.9%，민감성분별위68.8%、75.0%、75.0%、43.8%、56.3%、62.5%，특이성분별위75.0%、75.0%、80.0%、90.0%、100.0%、85.0%。결론 MDCT능전면관찰갑상선결절양병변적대소、형태、수량、변연、강화、개화、유무낭변、여린근결구적관계급경부림파결정등황，대저사정상진행종합분석，대량악성적감별구유중요개치。
Objective To discuss the value of multi-detector row spiral CT( MDCT) differential diagnosis in benign and malignant thyroid nodular lesions. Methods The MDCT and clinical data were reviewed and analyzed in 36 cases confirmed by surgical pathology and biopsy of patients with malignant thyroid nodular lesions. Results Malignant lesions in 16 cases, 20 patients with benign lesions. No statistical difference in the gender and age of the benign and malignant lesion (P>0.05). Malignant lesions showde single nodules mostly, irregular shape, unclear boundary, incomplete thyroid capsule, the invasion of adjacent structure and the enlargement of cervical lymph nodes. It had statistically difference compared with benign (P<0.05). There was no significant difference in focal calcified rate (P>0.05). But calcified form and part had statistically significant difference (P<0.05). Positive predictive value on irregular shape,unclear boundary, incomplete thyroid capsule,the invasion of adjacent structure and the enlargement of cervical lymph nodes for malignant diagnosis were 68.8 % 、70.6 %、75.0%、77.8 %、100.0 %、76.9 % respectively. Sensitivity were 68.8 %、75.0 %、75.0 %、43.8 %、56.3 %、62.5 % respectively. Specificity were 75.0 %、75.0 %、80.0 %、90.0%、100.0 %、85.0 % respectively. Conclusion MDCT can observe the thyroid nodular lesions roundly on the size, shape, number, edge, reinforcement, calcification, with cystic change or not, the relationship with the adjacent structures and cervical lymph nodes. Comprehensive analysis of these signs has important value to identify benign lesion and malignancy lesion.
