CT在甲状腺乳头状癌诊断及术前评估中的价值分析

目的:探讨CT平扫及增强扫描在甲状腺乳头状癌诊断及术前评估中的应用价值。方法:收集46例甲状腺乳头状癌患者资料,分析其平扫和增强扫描的CT征象进行术前评估,并对淋巴结转移与原发灶位置、大小及与甲状腺包膜关系进行统计。结果:CT平扫能清楚显示原发灶情况,结合增强扫描及冠状位或矢状位重建,可进一步明确肿瘤与周围组织结构的关系和转移情况;本组病例60.3%病灶为不规则形,46.7%患者可见微钙化,87.0%患者呈明显强化,87.0%患者增强后病灶范围较平扫缩小;中央区和颈侧区淋巴结转移与原发灶位置有统计意义(P=0.023),淋巴结转移组和非转移组在原发灶大小及与甲状腺包膜关系具有差异显著性(P<0.05)。结论:通过对CT平扫和增强的特征性征象分析,如病灶形态、微钙化、强化方式以及增强前后病灶范围变化等,可明显提高PTC的诊断率;同时对原发灶、周边侵犯及淋巴结转移情况进行综合评估,可以确定合理的手术切除范围和淋巴结清扫范围。此外统计发现淋巴结转移与原发灶位置、大小及与甲状腺包膜关系有一定的相关性。 

Value Analysis of CT in the Diagnosis and Preoperative Evaluation of Papillary Thyroid Carcinoma

Objective:To investigate the value of CT plain scan and enhancement in the diagnosis and preoperative evaluation of papillary thyroid carcinoma. Methods:Data of 46 patients with papillary thyroid carcinoma were collected, and CT features of plain and enhanced scans were analyzed for preoperative evaluation. The lymph node metastasis to the size and location of primary focus and the relationship between primary focus and thyroid capsule were analyzed. Results:CT plain scan can clearly showed the primary focus, combined with enhanced scan and coronal or sagittal reconstruction, it can further clarify the relationship between the tumor and the surrounding tissue structure and metastasis. In this group, 60.3% of the lesions were irregular, 46.7% of the patients had microcalcification, 87.0% of the patients showed marked enhancement, and the range of focus became smaller than before enhanced scan. There was statistical significance between the central lymph node metastasis and the cervical lymph node metastasis with the location of the primary focus(P=0.023), also there were statistical significance in the size of primary focus and the relationship with thyroid capsule between the lymph node metastasis group and the non metastasis group(P<0.05). Conclusion:The diagnostic rate of papillary thyroid carcinoma can be significantly improved by analyzing the characteristics of CT plain scan and enhancement, such as the focus shape, micro calcification, enhancement mode and the change of focus range before and after enhancement. Also the range of resection and lymph node dissection can be rational determined by comprehensive evaluation of primary focus, peripheral invasion and lymph node metastasis. In addition, we found there were a certain correlation between lymph node metastasis and he size and location of primary focus and the relationship between primary focus and thyroid capsule.