良、恶性甲状腺肿块的临床研究及超声及CT的征象分析(1)
摘要：目的 探讨良、恶性甲状腺肿块的临床特点及超声、CT诊断价值。方法 收集经手术病理证实为甲状腺肿块的68例(108个甲状腺结节)患者的临床资料，所有患者术前均已接受超声及CT检查，观察良、恶性甲状腺结节患者图像特点，总结其CT及超声征象，分析两者在良、恶性甲状腺肿块鉴别中的价值。结果 良性结节患者年龄大于恶性组(P<0.05)，超声及CT测定结节直径对比差异无统计学意义(P>0.05)，但良性组结节直径均高于恶性组(P<0.05)；良性结节以囊变征多见，恶性结节以钙化或微小钙化多见。结论 超声与CT鉴别良恶性甲状腺肿块图像一致性高，超声在微小甲状腺结节、结节内钙化及囊变显示方面优于CT，CT对甲状腺结节边缘及包膜显示情况优于超声。
关键词：甲状腺肿块；鉴别；超声；CT；征象
Abstract：Objective To investigate the clinical features of benign and malignant thyroid masses and to evaluate the diagnostic value of ultrasound and CT. Methods The clinical data of 68 patients (108 thyroid nodules) confirmed by operation and pathology were collected. All patients underwent ultrasound and CT examination before operation. The image characteristics of benign and malignant thyroid nodules were observed. The CT and ultrasound findings were summarized. The value of the two in the differentiation of benign and malignant thyroid masses was analyzed. Results Patients with benign nodules were older than those with malignant ones (P<0.05). There was no significant difference in the diameter of nodules measured by ultrasound and CT (P>0.05) but the diameter of benign nodules was higher than that of the malignant ones (P<0.05)； Benign nodules mostly showed cystic signs while malignant nodules mainly showed calcification or tiny calcification. Conclusion The image consistency of ultrasound and CT in differential diagnosis of benign and malignant thyroid masses is high. Ultrasound has more advantages over CT in displaying thyroid nodules， calcification in nodules and cystic changes while CT has more advantages over ultrasound in displaying thyroid edges of nodules and capsule.
, 百拇医药
Key words：Thyroid mass；Differentiation；Ultrasound；CT；Sign
甲狀腺疾病为临床常见内分泌疾病，发病率仅次于糖尿病[1]。统计显示，成人群体中，甲状腺结节触诊检出率为4%～9%，CT及超声诊断检出率超过60%，约有50%的甲状腺结节触诊正常者可经CT或超声检出[2]。但良恶性甲状腺结节治疗方式存在差异，预后不尽相同，早期检出病灶并鉴别其良恶性对临床治疗方式的选择有重要的指导价值[3]。近年来，超声及CT在甲状腺结节鉴别诊断中得到广泛应用，两者各具优势，但仅有极少数文献对两者在甲状腺结节鉴别诊断中的价值进行对比。为总结甲状腺良、恶性肿块临床特点及超声、CT征象与诊断价值，我院对收治的68例甲状腺结节患者的临床资料进行了回顾性分析，现报道如下：
1资料与方法
1.1一般资料 收集2012年4月～2015年8月经手术病理证实为甲状腺肿块的68例(108个结节)患者，其中男18例，女50例；年龄10～78岁，平均(45.8±5.9)岁；单发结节33例，多发35例；其中恶性甲状腺肿块33例(60个结节)，乳头状癌25例(46个结节)，滤泡癌5例(8个结节)，髓样癌2例(4个结节)，未分化癌1例(2个结节)，良性肿块35例(48个结节)，甲状腺瘤9例(12个结节)，结节性甲状腺肿19例(26个结节)，桥本甲状腺炎伴结节5例(7个结节)，甲状腺纤维钙化结节2例(3个结节)。所有患者术前均接受超声及CT检查，且影像学资料完整。
1.2检查方法 ①CT检查。采用Siemens Sensation 16层螺旋CT扫描仪，自耳下侧扫描至主动脉弓上处，设定电流200 mAs，电压120 kV，层厚3 mm，层间距3 mm，先作常规平扫，后经肘静脉注射非离子造影剂碘帕醇注射液，速率3.0 ml/s，剂量1.5 ml/kg，延迟60 s。②超声检查。采用Toshiba Nemio彩色多普勒超声检测仪，患者仰卧，颈部垫枕，头略后仰，头低肩高位，探头放于软骨下方，作横切、纵切扫查，设定探头频率分别为7.5 MHz、20 MHz。, 百拇医药(张得峰)
关键词：甲状腺肿块；鉴别；超声；CT；征象
Abstract：Objective To investigate the clinical features of benign and malignant thyroid masses and to evaluate the diagnostic value of ultrasound and CT. Methods The clinical data of 68 patients (108 thyroid nodules) confirmed by operation and pathology were collected. All patients underwent ultrasound and CT examination before operation. The image characteristics of benign and malignant thyroid nodules were observed. The CT and ultrasound findings were summarized. The value of the two in the differentiation of benign and malignant thyroid masses was analyzed. Results Patients with benign nodules were older than those with malignant ones (P<0.05). There was no significant difference in the diameter of nodules measured by ultrasound and CT (P>0.05) but the diameter of benign nodules was higher than that of the malignant ones (P<0.05)； Benign nodules mostly showed cystic signs while malignant nodules mainly showed calcification or tiny calcification. Conclusion The image consistency of ultrasound and CT in differential diagnosis of benign and malignant thyroid masses is high. Ultrasound has more advantages over CT in displaying thyroid nodules， calcification in nodules and cystic changes while CT has more advantages over ultrasound in displaying thyroid edges of nodules and capsule.
, 百拇医药
Key words：Thyroid mass；Differentiation；Ultrasound；CT；Sign
甲狀腺疾病为临床常见内分泌疾病，发病率仅次于糖尿病[1]。统计显示，成人群体中，甲状腺结节触诊检出率为4%～9%，CT及超声诊断检出率超过60%，约有50%的甲状腺结节触诊正常者可经CT或超声检出[2]。但良恶性甲状腺结节治疗方式存在差异，预后不尽相同，早期检出病灶并鉴别其良恶性对临床治疗方式的选择有重要的指导价值[3]。近年来，超声及CT在甲状腺结节鉴别诊断中得到广泛应用，两者各具优势，但仅有极少数文献对两者在甲状腺结节鉴别诊断中的价值进行对比。为总结甲状腺良、恶性肿块临床特点及超声、CT征象与诊断价值，我院对收治的68例甲状腺结节患者的临床资料进行了回顾性分析，现报道如下：
1资料与方法
1.1一般资料 收集2012年4月～2015年8月经手术病理证实为甲状腺肿块的68例(108个结节)患者，其中男18例，女50例；年龄10～78岁，平均(45.8±5.9)岁；单发结节33例，多发35例；其中恶性甲状腺肿块33例(60个结节)，乳头状癌25例(46个结节)，滤泡癌5例(8个结节)，髓样癌2例(4个结节)，未分化癌1例(2个结节)，良性肿块35例(48个结节)，甲状腺瘤9例(12个结节)，结节性甲状腺肿19例(26个结节)，桥本甲状腺炎伴结节5例(7个结节)，甲状腺纤维钙化结节2例(3个结节)。所有患者术前均接受超声及CT检查，且影像学资料完整。
1.2检查方法 ①CT检查。采用Siemens Sensation 16层螺旋CT扫描仪，自耳下侧扫描至主动脉弓上处，设定电流200 mAs，电压120 kV，层厚3 mm，层间距3 mm，先作常规平扫，后经肘静脉注射非离子造影剂碘帕醇注射液，速率3.0 ml/s，剂量1.5 ml/kg，延迟60 s。②超声检查。采用Toshiba Nemio彩色多普勒超声检测仪，患者仰卧，颈部垫枕，头略后仰，头低肩高位，探头放于软骨下方，作横切、纵切扫查，设定探头频率分别为7.5 MHz、20 MHz。, 百拇医药(张得峰)