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目的 探讨增强CT扫描在甲状腺肿瘤鉴别诊断中的价值及重要性。方法 回顾性分析经手术及病理证实的 2 7例甲状腺肿瘤的术前CT增强前后表现 ,其中甲状腺腺瘤 18例 ,甲状腺乳头状癌 9例。结果 增强扫描 18例腺瘤中 ,12例囊性腺瘤有完整性强化环 ,6例实体腺瘤瘤内岛形强化结节。 9例乳头状癌中均无完整强化环 ,其中 4例瘤壁强化结节。 9例乳头状癌中 7例瘤内有钙化 (呈斑点状、细颗粒状或二者混合状 ) ,4例甲状腺周围器官侵犯。结论 甲状腺肿瘤必须强调增强扫描才能显示甲状腺肿瘤的病理特征 ,对鉴别诊断具有重要价值。甲状腺周围器官侵犯是诊断甲状腺癌的肯定征象。瘤壁乳头状强化结节和瘤内斑点状、颗粒状钙化是甲状腺乳头状癌的可靠诊断征象。瘤周完整性强化环、瘤壁光滑锐利是良性腺瘤的征象
Objective To investigate the value and importance of enhanced CT in the differential diagnosis of thyroid neoplasms. Methods A retrospective analysis of the preoperative and post-enhanced CT findings of 27 thyroid tumors confirmed by surgery and pathology, including 18 cases of thyroid adenomas and 9 cases of thyroid papillary carcinoma. Results Enhanced scan In 18 cases of adenomas, 12 cases of cystic adenomas had integral reinforcement rings, and 6 cases of solid adenomas had island-like enhanced nodules. Nine cases of papillary carcinoma had no intact reinforcement ring, and 4 cases had nodules reinforced by the tumor wall. Of the 9 cases of papillary carcinoma, 7 cases had calcification in the tumor (in the form of spots, fine granules or a mixture of the two), and 4 cases of thyroid gland involvement. Conclusion Thyroid tumors must emphasize enhanced scans to show the pathological features of thyroid tumors, which is of great value for differential diagnosis. Peripheral organ invasion is a positive sign for the diagnosis of thyroid cancer. Papillary enhanced nodules in the wall and spot-like, granular calcification in the tumor are reliable diagnostic signs of papillary thyroid carcinoma. Peri-tumoral integrity enhancement ring, smooth and sharp tumor wall are signs of benign adenoma