摘要
目的 探讨儿童甲状腺肿瘤良、恶性结节的CT表现及其与组织病理的相关性.方法 回顾性分析上海市儿童医院2014年6月至2017年10月收治有明确病理诊断的28例甲状腺结节患儿的临床资料,对其CT影像学特征和病理结果进行对照分析.结果 甲状腺良性、恶性及恶性潜能未定肿瘤结节分别为35个（11例）、15个（10例）和8个（7例）,共58个.良性结节、恶性潜能未定结节均有包膜（100.0％）,其中良性结节4个（11.4％,4/35个）包膜不完整,恶性潜能未定结节中1个（12.5％,1/8个）包膜不完整,恶性结节11个（73.3％,11/15个）无包膜、4个（26.7％,4/15个）包膜不完整;良性结节中9个为囊性（25.7％,9/35个）,其余均为囊实性、实性（74.3％,26/35个）,恶性结节及恶性潜能未定结节均表现为囊实性、实性;良性结节及恶性潜能未定结节大多边缘清晰,恶性结节边缘不清;良性结节病例中2例（18.2％,2/11例）有钙化,恶性结节8例（80.0％,8/10例）有钙化,恶性潜能未定结节3例（42.9％,3/7例）有钙化;良性及恶性潜能未定肿瘤患者未见淋巴结转移,恶性结节中7例（70.0％,7/10例）患儿伴淋巴结大、转移.肿块边界清晰与否、包膜完整与否、有无钙化、周围淋巴结大对于鉴别良、恶性具有一定的参考价值.CT诊断结果和术后病理组织诊断的符合率在良性、恶性与恶性潜能未定结节分别为61.1％（11/18例）、90.0％（9/10例）、14.3％（1/7例）,恶性潜能未定结节影像表现缺乏特异性,明确诊断需依据病理.结论 甲状腺结节CT影像学特征和病理存在一定关系,对儿童甲状腺结节的诊断及鉴别诊断有重要价值.
Objective To investigate the CT features of benign and malignant thyroid nodules in children and their correlation with histopathology of thyroid nodules.Methods The clinical data of 28 children with thyroid nodules confirmed by pathological diagnosis in Shanghai Children＇s Hospital from June 2014 to October 2017 were retrospectively analyzed.The CT imaging features and pathological results were compared and analyzed.Results The thyroid nodules of benign,malignant and uncertain malignant potential nodules in this group respectively were 35 nodules （11 cases）,15 nodules （10 cases） and 8 nodules （7 cases） respectively,with a total of 58 nodules.Benign and uncertain malignant potential nodules were all（100.0%） enveloped,4 nodules（11.4%,4/35 nodules） were benign nodules and 1 nodule （12.5%,1/8 nodules） was uncertain malignant potential nodules and its capsule was incomplete.There were 11 nodules （73.3%,11/35 nodules） malignant nodules without capsule and 4 nodules（26.7%,4/15 nodules） were malignant nodules with incomplete capsule.In the benign nodules,9 nodules（25.7%,9/35 nodules） of them were cystic,and the others were solid or solid cystic （74.3 %,26/35 nodules）.All of the malignant nodules and uncertain malignant potential nodules were solid or solid cystic nodules.Benign nodules and uncertain malignant potential nodules were mostly had clear edges,but the edges of malignant nodules were not clear.There were 2 cases （18.2%,2/ll cases） of the benign nodules which had calcification,8 cases（80.0%,8/10 cases） of the malignant nodules had calcification,and 3 cases （42.9%,3/7 cases）of the uncertain malignant potential nodules had calcification.There was no lymph node metastasis in the patients with benign and uncertain malignant potential nodules.In the malignant nodules,there were 7 cases with lymph node metastasis,accounting for 70.0% （7/10 cases）.It had certain reference value for the differentiation of benign and malignant nodules to know whether the boundary of the mass was clear or not,whether the capsule was intact or not,and whether there was calcification or not.The surrounding lymph node enlargement had certain reference value for the differential diagnosis of benign and malignant nodules.The diagnostic results of CT and the coincidence rate of pathological histological diagnosis after operation,the benign nodules and malignant nodules,and also the uncertain malignant potential were respectively 61.1% （11/18 cases）,90.0% （9/10 cases） and 14.3% （1/7 cases）.The thyroid nodules of uncertain malignant potential CT imaging were lack of specificity,and definite diagnosis should be based on pathology.Conclusions There is a certain relationship between CT imaging features and pathology of thyroid nodules,which is of great value for the diagnosis and differential diagnosis of thyroid nodules in children.
作者
刘菁华
杨秀军
张斌
Liu Jinghua, Yang Xiajun, Zhang Bin(Department of Radiology and Medicine Imaging, Shanghai Children＇s Hospital/Children＇s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200040, Chin)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2018年第8期580-584,共5页
Chinese Journal of Applied Clinical Pediatrics
作者简介
通信作者：杨秀军，Email：woothingyang2008@126．com
