关键词：甲状腺肿瘤；肿瘤复发，局部；肿瘤转移；体层摄影术，X线计算机
【摘要】 目的 分析甲状腺癌术后复发的CT表现，了解甲状腺癌术后复发的特点。方法 回顾性分析经手术及病理证实的甲状腺癌术后复发患者42例，包括乳头状癌25例，滤泡癌9例，髓样癌6例，透明细胞癌2例。结果 甲状腺床局部复发23例，其中侵犯颈动脉10例，气管、食管17例，喉及下咽2例，9例滤泡癌中8例局部复发，7例肿物明显强化。对侧甲状腺复发12例，病理类型与原发甲状腺癌一致。颈部淋巴结转移31例，乳头状癌颈部淋巴结转移率为76%。纵隔淋巴结转移7例。75%的患者复发形式多于一种。结论 甲状腺癌术后复发部位以颈部淋巴结转移及甲状腺床局部复发为主，滤泡癌术后复发以术床局部复发最多见，而乳头状癌术后复发以颈部淋巴结转移最多见；甲状腺床局部复发肿物常有邻近器官结构明显受侵。
CT manifestations ofrecurrent thyroid carcinoma
LUO Dehong, SHI Mulan.
Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences,Beijing Union Medical University, Beijing 100021
【 Abstract】 Objective To study the CT manifestations ofrecurrent thyroid carcinoma, in order to recognize the characteristics of recurrentthyroid carcinoma. Methods 42 cases of recurrent thyroid carcinoma proved by surgeryand pathology were reviewed, including papillary carcinoma (n=25), follicular carcinoma(n=9), medullary carcinoma (n=6) and clear cell carcinoma (n=2). Results Local recurrence in thyroid bedwas found in 23 cases. Invasion of carotid artery (n=2), trachea and esophagus (n=17),larynx and hypopharynx (n=2) was revealed by CT. In 9 cases of follicular carcinoma 8 hadlocal thyroid bed recurrence. All of the 7 cases with contrast administration hadenhancement of tumor mass. Recurrence of contralateral lobe was seen in 12 cases, thepathologic types were the same as the primary carcinoma. Cervical lymph node metastaseswere proved in 31 cases, being the major manifestation of papillary carcinoma (76%).Mediastinal lymph node metastases were found in 7 cases . 75% of patients had more thanone type of recurrences. Conclusion The majority of recurrent thyroid carcinoma were found incervical lymph node and thyroid bed. Thyroid bed recurrence was most commonly seen infollicular carcinoma while cervical lymph node metastasis were frequent in papillarycarcinoma . The adjacent organs or structures was of ten invaded by local recurrent tumor.
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