甲状腺癌螺旋c与高频超声影像特征的对照研究.pdf

甲状腺癌螺旋CT 与高频超声影像特征的对照研究 研究生：杨帆 导师：文智 副教授 摘 要 目的：分析甲状腺癌的螺旋 CT (spiral CT, SCT) 与高频超声(high-frequency ultrasound, US)表现，探讨两种检查方法联合应用对甲状腺癌的诊断价值。方法：回 顾性分析 136 例甲状腺癌的高频 US 和 SCT 表现，并与手术及病理结果对照。136 例均行高频US 和SCT 检查，CT 都对比增强扫描和多平面重建（MPR ）来鉴别原发 性肿瘤和颈部转移淋巴结。结果：高频 US 和SCT 诊断结果与病理结果进行对比分 析。高频US 对甲状腺癌的检出率为54.0 ％(74/136)，SCT 为76.0 ％(103/136)，P0.05 两者有统计学意义；SCT 与高频超声联合应用的检出率为83.0 ％（113/136）。136 例 甲状腺癌螺旋CT 显示率94.9%(129/136)，高频US 显示率98.5%(134/136) 。螺旋CT 检出30 个病灶微钙化，高频US 检出46 个病灶微钙化，两者有显著性差异(P0.05) 。 对于颈部淋巴结转移诊断US 的诊断符合率为75.7 ％，CT 为62.5 ％，两者有显著性 差异(P0.05) 。结论：高频超声作为甲状腺癌的首选和重要检查方法，螺旋CT 在评 价甲状腺癌的原发灶、颈部淋巴结转移方面有一定特征性，两种检查方法联合应用， 可以提高甲状腺癌术前评估和诊断的准确性。 关键词: 甲状腺癌； 螺旋CT ； 高频超声 —1— Comparative Study on Spiral CT and Ultrasound Imaging Characteristics of Thyroid Carcinoma Postgraduate:Yang Fan Tutor:Wen Zhi vice professor Abstract Objective: To study the spiral CT(SCT) and high-frequence ultrasound(US) appearances of preoperative thyroid carcinoma, to evaluate the value of Spiral CT combined with high-frequence ultrasound(US)in diagnosing thyroid carcinoma. Methods: The US and SCT appearance in 136 cases of thyroid carcinoma, confirmed with operation and pathology, were analyzed retrospectively. All the patients had both high-frequence US and SCT examinations. SCT with contrast-enhanced scan and multiplanar reconstruction (MPR)were all employed to differentiate primary tumor and metastatic lymph node in the neck. Result: The final detection rate of thyroid carcinoma with high-frequence US was 54.0%, and SCT was 76.0%, There was significantly difference between SCT and US(P0.05); The final detection rate of the spiral CT (SCT) and high-