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论著:甲状腺癌的磁共振成像诊断
MRI Characteristics of Thyroid Carcinoma
邱海英 强金伟 冯琴 李若坤 廖治河
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作者单位:复旦大学附属金山医院放射科
中文关键字:甲状腺癌;磁共振成像
英文关键字:Thyroid carcinoma; Magnetic resonance imaging
中文摘要:目的:分析甲状腺癌的磁共振成像(MRI)表现,提高甲状腺癌的诊断水平。方法:27例经手术和病理证实的甲状腺癌患者(乳头状癌23例,滤泡状癌2例,未分化癌和转移癌各1例)行MRI检查,男性7例,女性20例,年龄26~68岁,平均年龄48岁。观察癌结节的大小、数量、形态、边缘、信号类型、强化方式。结果:27例甲状腺癌共33个癌结节,其中单发结节23例(85%),多发结节4例(15%)。形态不规则30个,类圆形3个。T1WI呈等或略低信号32个,不规则等和高信号1个;T2WI呈均匀或不均匀高信号31个,等信号2个;结节边缘见不完整低信号环9个。增强后结节均有不同程度强化;边缘明显环形强化、中央强化稍低8个,其中 “残圈征”6个,表现为结节周边强化环连续性中断、不完整;均匀强化6个;不均匀强化19个,其中乳头样强化3个,半岛样强化3个。颈部淋巴结转移7例,其中5例信号和强化不均匀。 结论:甲状腺癌具有一定的形态学特征,了解其MRI表现有助于明确诊断。
英文摘要:Objective: To study the magnetic resonance imaging (MRI) features of thyroid carcinoma to improve its diagnosis. Methods: The MRI was performed in 27 patients with surgically and pathologically proven thyroid carcinoma, including 23 with papillary carcinomas, two with follicular carcinoma, one with undifferentiated carcinoma and one with metastasis. The subjects were 20 women and 7 men with age range of 26-68 years (mean, 48 years). The number, size, shape, margin, signal characteristics, and enhancement patterns of cancer nodules were evaluated. Results: Thirty three cancer nodules were found with single nodule in 23 (85%) cases and multiple nodules in 4 (15%) cases. Thirty (91%) nodules were ill defined and irregular, while the remaining 3 (9%) nodules were well-defined and regular. On T1WI, 32 nodules appeared the isointense or slight hypointense, and only one nodules was mixed iso-, and hyperintense. On T2WI, 31 nodules were hyperintense with homogeneous or heterogeneous composition, the remaining 2 nodules isointense. Incomplete low signal ring was identified in 9 nodules. After the administration of contrast material, all nodules demonstrated mild to marked enhancement with marked enhanced ring and morderate enhanced center in 8 nodules, homogeneous enhancement in 6 nodules, and heterogeneous enhancement in 19 nodules. Seven patients appeared metastatic lympadenopathy in the neck with heterogeneous signal and enhancement in 5 cases. Conclusions: MRI can demonstrate some valuable characteristics of thyroid carcinoma which are helpful for making a correct diagnosis.
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