CAJ | 학술논문

目的：探讨甲状腺乳头状癌淋巴结转移的CT特征性表现，提高甲状腺乳头状癌淋巴结转移的诊断正确率，为外科手术方案和手术范围选择提供可靠依据。方法回顾分析经手术病理证实的共334例甲状腺乳头状癌患者的CT影像资料，对其中141例发生颈部淋巴结转移的病例进行统计学分析。结果141例患者中包括仅有中央区（Ⅵ区）淋巴结转移79例，CT诊断符合为60例；中央区及侧颈区（Ⅱ～Ⅴ区）均转移者62例， CT诊断符合51例。结果采用χ2检验。102例淋巴结密度、强化程度与甲状腺癌相似，其中23例伴有囊变坏死，14例伴有颗粒状钙化灶，7例并发喉返神经侵犯或气管、血管侵犯。结论甲状腺癌转移淋巴结好发部位为中央区；但侧颈区亦同样常常有转移，应高度重视。转移淋巴结的CT扫描特征：淋巴结明显强化，强化程度与甲状腺乳头状癌保持一致，可发生囊性变或坏死，以及出现颗粒状钙化灶，CT检查对临床手术方案制定具有重要指导意义。
목적：탐토갑상선유두상암림파결전이적CT특정성표현，제고갑상선유두상암림파결전이적진단정학솔，위외과수술방안화수술범위선택제공가고의거。방법회고분석경수술병리증실적공334례갑상선유두상암환자적CT영상자료，대기중141례발생경부림파결전이적병례진행통계학분석。결과141례환자중포괄부유중앙구（Ⅵ구）림파결전이79례，CT진단부합위60례；중앙구급측경구（Ⅱ～Ⅴ구）균전이자62례， CT진단부합51례。결과채용χ2검험。102례림파결밀도、강화정도여갑상선암상사，기중23례반유낭변배사，14례반유과립상개화조，7례병발후반신경침범혹기관、혈관침범。결론갑상선암전이림파결호발부위위중앙구；단측경구역동양상상유전이，응고도중시。전이림파결적CT소묘특정：림파결명현강화，강화정도여갑상선유두상암보지일치，가발생낭성변혹배사，이급출현과립상개화조，CT검사대림상수술방안제정구유중요지도의의。
Objective To investigate the CT features of thyroid papillary carcinoma lymph node metastasis, im-prove the correct diagnosis rate of thyroid papillary carcinoma with lymph node metastasis, and provide a reliable ba-sis for surgical operation scheme and operation range selection. Methods Retrospectively analyze the CT image data of 334 cases with thyroid papillary carcinoma patients confirmed by operation and pathology, among them 141 cases with lymph node metastasis were statistically analyzed. Results Of 141 patients , 79 cases showed the central area (area Ⅵ) lymph node metastasis , and 60 cases were consistent by CT diagnosis. Sixty-two cases showed central and lateral neck area (area Ⅱ-Ⅴ) of metastasis and 51 cases were consistent by CT diagnosis. The results were analysed by chi-square test. A total of 102 cases of lymph node density and the strengthening degree were similar to thyroid carcinoma, including 23 cases with cystic necrosis, 14 cases accompanied with granular calcification, 7 cases compli-cated by recurrent laryngeal nerve invasion, vascular invasion or trachea. Conclusion The primary site for lymph node metastasis of thyroid carcinoma is central region,and neck region also often is involved, which should pay atten-tion to. CT scanning characteristics of lymph node metastasis of lymph node were showed as follows:lymph node en-hanced obviously, and the enhancement extent was consistent with thyroid papillary carcinoma, it may transferred to cystic degeneration or necrosis, and granular calcification, CT examination has an important guiding significance for clinical operation plan.