摘要
目的:探讨甲状腺髓样癌(MTC)、滤泡癌(FTC)的CT表现与病理的相关性,评价CT在鉴别诊断中的价值。方法:回顾性分析手术病理证实的21例25个MTC、15例FTC的CT表现与病理特征。结果:①平扫时两者密度、边界及钙化形式无统计学差异(P=0.444,P=0.139,P=0.325)。②增强扫描显示两者边界表现不同,MTC(17/22)较FTC(6/15)不清晰(P=0.038)。病理显示MTC多无包膜且呈浸润性生长,而FTC则包膜完整或仅有局部包膜侵犯。③4个MTC和3个FTC由平扫时的密度均匀变为增强后的不均匀,病理基础前者肿瘤中含有淀粉样物质,而后者则为胶原组织。④边界清晰与否在增强前后发生变化的4个MTC和5个FTC均与肿瘤有无包膜及血供丰富程度相关。⑤MTC(18/21)较FTC(1/15)更易发生颈部淋巴结转移(P<0.001)。结论:CT平扫与增强扫描对鉴别甲状腺髓样癌和滤泡癌有意义,CT特征与病理改变密切相关。
Purpose： To evaluate the relationship between the CT features and pathologic findings of medullary thyroid carcinoma （MTC） and follicular thyroid carcinoma （FTC）. Methods：The CT features of 21 patients with 25 MTC lesions and 15 FTC lesions were analyzed retrospectively, the pathologic findings were compared. Results： （1）The lesion density,border and calcification shape of these two kinds of lesions on CT plain imagings were not different significantly （P = 0. 444, P = 0. 139, P = 0. 325） . ②On enhenced CT imagings, the lesion border of these two kinds of cancers was different, MTC＇ s （17/22） border was less clear than that of FTC （6/15）（P = 0. 038）. Compared with the Pathology, MTC general appeared no capsule and invasion, while FTC appeared capsule integrity or merely invaded partly. ③The density of 4 MTC and 3 FTC became heterogeneous on postcontrast CT imagings, histologic findings showed massive amyloid deposits in MTC, while a lot of collagen in FTC. ④The border features of 4 MTC and 5 FTC on plain and contrast CT were changed, which had relationship with the lesion＇s capcule and neoplastic capillary vessels. ⑤ MTC （18/21） was more easy to have cervical lymph nodes metastases than FTC （1/15）, and there was significant difference（P 〈 0. 001）. Conclusion： Plain and enhanced CT imagings were helpful in the differential diagnosis of MTC and FTC. CT features linked closely to pathologic appearances.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2009年第1期25-30,共6页
Chinese Computed Medical Imaging
作者简介
通信作者：顾雅佳（电子邮箱：cjr．guyajia@vip．163.com）
