• 1.四川大學華西醫(yī)院放射科(四川成都 610041);;
  • 2.四川大學華西醫(yī)院病理科(四川成都 610041);

目的  探討甲狀腺乳頭狀癌的多層螺旋CT(MSCT)表現(xiàn)及特征。
方法  回顧性分析2013年5~6月期間四川大學華西醫(yī)院甲狀腺外科收治的35例甲狀腺乳頭狀癌患者的術(shù)前MSCT資料,觀察其影像學表現(xiàn)與特征。
結(jié)果  35例患者中,24例(68.6%)為單發(fā)病灶,11例(31.4%)為2~3個病灶;22例(62.9%)出現(xiàn)頸部淋巴結(jié)轉(zhuǎn)移。MSCT共計顯示甲狀腺乳頭狀癌病灶48個,有29.2% (14/48)的病灶位于左葉,有70.8% (34/48)的病灶位于右葉;病灶最大徑0.4~5.8cm,平均1.3cm;有39.6% (19/48)的病灶密度不均勻,有25.0% (12/48)的病灶形態(tài)不規(guī)則,有47.9% (23/48)的病灶邊緣模糊欠清,有18.8% (9/48)的病灶顯示為乳頭狀強化瘤結(jié)節(jié),有10.4% (5/48)的病灶瘤周出現(xiàn)“強化殘圈”征,有22.9% (11/48)的病灶侵犯周圍脂肪間隙或鄰近器官。有35.4% (17/48)的病灶出現(xiàn)鈣化,其中有76.4% (13/17)呈細粒狀鈣化,11.8% (2/17)呈粗鈣化,11.8% (2/17)呈混合性鈣化。
結(jié)論  甲狀腺乳頭狀癌的MSCT表現(xiàn)具有一定的特征性,可為臨床治療方案的選擇提供影像學依據(jù)。

引用本文: 漆銳,肖家和,余建群,姜勇,黃子星. 多層螺旋CT對甲狀腺乳頭狀癌影像表現(xiàn)的評價. 中國普外基礎與臨床雜志, 2013, 20(9): 1060-1064. doi: 復制

1. 謝榜昆, 關(guān)玉寶, 袁小平, 等. 甲狀腺癌的CT表現(xiàn)與病理相關(guān)性研究[J]. 癌癥, 2003, 22(2):192-197.
2. Nix P, Nicolaides A, Coatesworth AP. Thyroid cancer review:presentation and investigation of thyroid cancer[J]. Int J Clin Pract, 2005, 59(11):1340-1344.
3. King AD. Imaging for staging and management of thyroid cancer[J]. Cancer Imaging, 2008, 8(1):57-69.
4. 羅德紅, 石木蘭, 羅斗強. 甲狀腺癌的CT診斷[J]. 中華放射學雜志, 1998, 32(11):758-760.
5. 羅德紅, 石木蘭, 徐震綱, 等. 頸部轉(zhuǎn)移淋巴結(jié)的CT、B超掃描與病理對照研究(Ⅰ. 轉(zhuǎn)移淋巴結(jié)的診斷標準)[J]. 中華放射學雜志, 1997, 31(9):608-613.
6. 肖云峰, 顏廣林, 何銀, 等. 甲狀腺乳頭狀癌及淋巴結(jié)轉(zhuǎn)移的CT表現(xiàn)[J]. 醫(yī)學影像學雜志, 2008, 18(10):1106-1108.
7. 賈穎軍, 王亞非, 顧建平, 等. 甲狀腺乳頭狀癌的64層螺旋CT診斷[J]. 醫(yī)學影像學雜志, 2011, 21(8):1161-1163.
8. Khoo ML, Asa SL, Witterick IJ, et al. Thyroid calcification and its association with thyroid carcinoma[J]. Head Neck, 2002, 24(7):651-655.
9. Hoang JK, Lee WK, Lee M, et al. US features of thyroid malignancy:pearls and pitfalls[J]. Radiographics, 2007, 27(3):847-860.
10. Chammas MC, de Araujo Filho VJ, Moysés RA, et al. Predictivevalue for malignancy in the finding of microcalcifications on ultra-sonography of thyroid nodules[J]. Head Neck, 2008, 30(9):1206-1210.
11. Seiberling KA, Dutra JC, Grant T, et al. Role of intrathyroidal calcifications detected on ultrasound as a marker of malignancy[J]. Laryngoscope, 2004, 114(10):1753-1757.
12. Kim BK, Choi YS, Kwon HJ, et al. Relationship between patternsof calcification in thyroid nodules and histopathologic findings[J].Endocr J, 2013, 60(2):155-160.
13. Gungor B, Polat AK, Polat C, et al. Do the calcifications in the thyroid gland predict malignancy?[J]. Bratisl Lek Listy, 2012, 113(9):552-555.
14. 呂英志, 柳劍英, 廖松林. 結(jié)節(jié)性甲狀腺腫與甲狀腺癌關(guān)系的探討[J]. 中華普通外科雜志, 2004, 19(5):298-300.
15. King AD, Ahuja AT, To EW, et al. Staging papillary carcinoma of the thyroid:magnetic resonance imaging vs. ultrasound of the neck[J]. Clin Radiol, 2000, 55(3):222-226.
16. 朱國獻, 林勇杰. 結(jié)節(jié)性甲狀腺腫與甲狀腺癌并存的診斷與治療(附68例臨床報告)[J]. 中國現(xiàn)代醫(yī)學雜志, 2002, 12(10):75-76.
17. 譚紅娜, 顧雅佳, 彭衛(wèi)軍, 等. 甲狀腺乳頭狀癌的CT表現(xiàn)與病理對照分析[J]. 中華放射學雜志, 2009, 43(8):799-804.
18. Kaji AV, Mohuchy T, Swartz JD. Imaging of cervical lymphadenopathy[J]. Semin Ultrasound CT MR, 1997, 18(3):220-249.
19. 羅德紅, 石木蘭, 李復. 甲狀腺癌淋巴結(jié)轉(zhuǎn)移的CT表現(xiàn)[J]. 中華放射學雜志, 2002, 36(1):36-39.
20. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings[J]. Radiol Clin North Am, 2000, 38(5):1105-1129.
21. 任立軍, 楊延芳, 張成雷. 甲狀腺乳頭狀癌淋巴結(jié)轉(zhuǎn)移規(guī)律的臨床研究[J]. 中國普外基礎與臨床雜志, 2011, 18(4):419-422.
22. 高慶軍, 王南鵬, 周彥, 等. 甲狀腺乳頭狀癌頸部淋巴結(jié)轉(zhuǎn)移規(guī)律及影響因素分析[J]. 中國普外基礎與臨床雜志, 2013, 20(3):303-309.
23. Summaria V, Rufini V, Mirk P, et al. Diagnostic imaging of differentiated thyroid carcinoma[J]. Rays, 2000, 25(2):177-190.
24. Ishikawa H, Tamaki Y, Takahashi M, et al. Comparison of primary thyroid lymphoma with anaplastic thyroid carcinoma on computed tomographic imaging[J]. Radiat Med, 2002, 20(1):9-15.
25. Choi JS, Kim J, Kwak JY, et al. Preoperative staging of papillarythyroid carcinoma:comparison of ultrasound imaging and CT[J].AJR Am J Roentgenol, 2009, 193(3):871-878.
  1. 1. 謝榜昆, 關(guān)玉寶, 袁小平, 等. 甲狀腺癌的CT表現(xiàn)與病理相關(guān)性研究[J]. 癌癥, 2003, 22(2):192-197.
  2. 2. Nix P, Nicolaides A, Coatesworth AP. Thyroid cancer review:presentation and investigation of thyroid cancer[J]. Int J Clin Pract, 2005, 59(11):1340-1344.
  3. 3. King AD. Imaging for staging and management of thyroid cancer[J]. Cancer Imaging, 2008, 8(1):57-69.
  4. 4. 羅德紅, 石木蘭, 羅斗強. 甲狀腺癌的CT診斷[J]. 中華放射學雜志, 1998, 32(11):758-760.
  5. 5. 羅德紅, 石木蘭, 徐震綱, 等. 頸部轉(zhuǎn)移淋巴結(jié)的CT、B超掃描與病理對照研究(Ⅰ. 轉(zhuǎn)移淋巴結(jié)的診斷標準)[J]. 中華放射學雜志, 1997, 31(9):608-613.
  6. 6. 肖云峰, 顏廣林, 何銀, 等. 甲狀腺乳頭狀癌及淋巴結(jié)轉(zhuǎn)移的CT表現(xiàn)[J]. 醫(yī)學影像學雜志, 2008, 18(10):1106-1108.
  7. 7. 賈穎軍, 王亞非, 顧建平, 等. 甲狀腺乳頭狀癌的64層螺旋CT診斷[J]. 醫(yī)學影像學雜志, 2011, 21(8):1161-1163.
  8. 8. Khoo ML, Asa SL, Witterick IJ, et al. Thyroid calcification and its association with thyroid carcinoma[J]. Head Neck, 2002, 24(7):651-655.
  9. 9. Hoang JK, Lee WK, Lee M, et al. US features of thyroid malignancy:pearls and pitfalls[J]. Radiographics, 2007, 27(3):847-860.
  10. 10. Chammas MC, de Araujo Filho VJ, Moysés RA, et al. Predictivevalue for malignancy in the finding of microcalcifications on ultra-sonography of thyroid nodules[J]. Head Neck, 2008, 30(9):1206-1210.
  11. 11. Seiberling KA, Dutra JC, Grant T, et al. Role of intrathyroidal calcifications detected on ultrasound as a marker of malignancy[J]. Laryngoscope, 2004, 114(10):1753-1757.
  12. 12. Kim BK, Choi YS, Kwon HJ, et al. Relationship between patternsof calcification in thyroid nodules and histopathologic findings[J].Endocr J, 2013, 60(2):155-160.
  13. 13. Gungor B, Polat AK, Polat C, et al. Do the calcifications in the thyroid gland predict malignancy?[J]. Bratisl Lek Listy, 2012, 113(9):552-555.
  14. 14. 呂英志, 柳劍英, 廖松林. 結(jié)節(jié)性甲狀腺腫與甲狀腺癌關(guān)系的探討[J]. 中華普通外科雜志, 2004, 19(5):298-300.
  15. 15. King AD, Ahuja AT, To EW, et al. Staging papillary carcinoma of the thyroid:magnetic resonance imaging vs. ultrasound of the neck[J]. Clin Radiol, 2000, 55(3):222-226.
  16. 16. 朱國獻, 林勇杰. 結(jié)節(jié)性甲狀腺腫與甲狀腺癌并存的診斷與治療(附68例臨床報告)[J]. 中國現(xiàn)代醫(yī)學雜志, 2002, 12(10):75-76.
  17. 17. 譚紅娜, 顧雅佳, 彭衛(wèi)軍, 等. 甲狀腺乳頭狀癌的CT表現(xiàn)與病理對照分析[J]. 中華放射學雜志, 2009, 43(8):799-804.
  18. 18. Kaji AV, Mohuchy T, Swartz JD. Imaging of cervical lymphadenopathy[J]. Semin Ultrasound CT MR, 1997, 18(3):220-249.
  19. 19. 羅德紅, 石木蘭, 李復. 甲狀腺癌淋巴結(jié)轉(zhuǎn)移的CT表現(xiàn)[J]. 中華放射學雜志, 2002, 36(1):36-39.
  20. 20. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings[J]. Radiol Clin North Am, 2000, 38(5):1105-1129.
  21. 21. 任立軍, 楊延芳, 張成雷. 甲狀腺乳頭狀癌淋巴結(jié)轉(zhuǎn)移規(guī)律的臨床研究[J]. 中國普外基礎與臨床雜志, 2011, 18(4):419-422.
  22. 22. 高慶軍, 王南鵬, 周彥, 等. 甲狀腺乳頭狀癌頸部淋巴結(jié)轉(zhuǎn)移規(guī)律及影響因素分析[J]. 中國普外基礎與臨床雜志, 2013, 20(3):303-309.
  23. 23. Summaria V, Rufini V, Mirk P, et al. Diagnostic imaging of differentiated thyroid carcinoma[J]. Rays, 2000, 25(2):177-190.
  24. 24. Ishikawa H, Tamaki Y, Takahashi M, et al. Comparison of primary thyroid lymphoma with anaplastic thyroid carcinoma on computed tomographic imaging[J]. Radiat Med, 2002, 20(1):9-15.
  25. 25. Choi JS, Kim J, Kwak JY, et al. Preoperative staging of papillarythyroid carcinoma:comparison of ultrasound imaging and CT[J].AJR Am J Roentgenol, 2009, 193(3):871-878.
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