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甲狀腺疾病的影像學評估與診斷－兼論病理學基礎
Imaging Assessment and Diagnosis in Thyropathy-with Exposition of Pathologic Basis
摘要
目的：本文以病理學爲基礎，闡述了甲狀腺疾病的影像學表現。方法：除比較各種影像學檢査之優缺點並進行評估外，還詳盡地分析了各種甲狀腺疾病的影像學（重CT與MRI）診斷和鑒別診斷要點。結果：甲狀腺疾病影像學顯示彌漫性或局限性甲狀腺腫大。彌漫性腫大常見於甲狀腺癌、甲狀腺腫、甲狀腺功能亢進和甲狀腺炎，呈現密度不均勻或均勻，常伴有鈣化或（和）囊變。前者（惡性）界限不清，輪廓不規則。良性結節（腺瘤）或囊腫則邊緣清楚，中度到明顯強化或不強化。結論：作者認爲：1.影像學對甲狀腺病變的定位診斷準確性較高，尤其CT和MRI；2.病灶的形態和邊緣及其強化程度在甲狀腺病變鑒別診斷方面有很大幫助。結合某些特殊徵象和血清學檢査，大多能作出定性診斷。
並列摘要
Objective: The thyropathy is analysed in imaging under the basis of pathology in the article. Methods: Besides assessing the methods of vary imaging examination for thyropathy, the diagnosis and differential diagnosis of imaging ( particularly CT and MRI ) are exposited for thyropathy in detail. Results: The enlarged thyroid gland is showed in imaging for thyropathy, including diffusive or local enlargement. The diffusive mass with non-homogeneous or homogeneous density is always seen in Carcinoma, Goiter, Hyperthyroidism and Thyroiditis consisting with calcification and (or) cystoid change, the poorly margin and irregular outline in foremost (malignant). A benignant node (adenoma) or cyst reveals the small mass with clear margin and moderated to stronger enhancement or no. Conclusion: Authors believe: 1. To determine the site of lesion in thyropathy is accurate by imaging check; 2. The shape, margin and enhancement degree of the focus are of more help in the differential diagnosis of thyropathy, most to can make accurate diagnosis combine with some special findings and serology examination.