Guan Yu-Bao, Xie Bang-Kun, Yuan Xiao-Ping, Li Hai-Gang
Department of Radiology, The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, PR China.
Ai Zheng. 2003 Jul;22(7):739-44.
BACKGROUND & OBJECTIVE: Magnetic resonance imaging (MRI) has been demonstrated to be important for the evaluation of thyroid diseases. Several foreign authors have reported MRI manifestation of thyroid carcinoma; however, there were few reports about this in China. This study was designed to investigate the diagnostic value of MRI in thyroid carcinoma by comparing MRI manifestation with histopathological features of thyroid carcinoma.
Thirty-one cases of thyroid carcinoma were analyzed retrospectively with preoperational MRI and postoperational pathological findings.
Among 31 cases of thyroid carcinoma, 20 cases showed heterogeneous intensity in MRI and liquefied or hemorrhagic or cystic degeneration at histopathological examination. Twenty-two cases showed ill defined. Twenty-two cases showed irregular shapes, of 10 cases showed "the discontinuous capsule-like sign with low signal intensity around the tumor" in MRI and that pseudocapsules have been penetrated and partially destroyed by tumors in histopathological findings. Nineteen cases showed the tumors infiltrated the adjacent structures. Nineteen cases showed metastatic lymphadenopathy on the neck.
"The discontinuous capsule-like sign with low signal intensity around the tumor" is the characteristic manifestation of thyroid carcinoma on MRI. Heterogeneous signal, obscure margin, and irregular shape are the important features for diagnosis of thyroid carcinoma. MRI can demonstrate small lesions, provide the precise morphologic characteristics of lesions, and accurately define the local extension of tumors.
磁共振成像(MRI)已被证明对甲状腺疾病的评估具有重要意义。一些国外作者报道了甲状腺癌的MRI表现;然而,国内关于这方面的报道较少。本研究旨在通过比较甲状腺癌的MRI表现与组织病理学特征,探讨MRI在甲状腺癌诊断中的价值。
回顾性分析31例甲状腺癌患者的术前MRI和术后病理结果。
31例甲状腺癌中,20例MRI表现为信号不均匀,组织病理学检查显示液化、出血或囊性变。22例边界不清。22例形态不规则,其中10例MRI表现为“肿瘤周围低信号强度的不连续包膜样征象”,组织病理学检查显示假包膜被肿瘤穿透并部分破坏。19例显示肿瘤侵犯邻近结构。19例显示颈部有转移性淋巴结肿大。
“肿瘤周围低信号强度的不连续包膜样征象”是甲状腺癌在MRI上的特征性表现。信号不均匀、边界模糊和形态不规则是诊断甲状腺癌的重要特征。MRI能够显示小病灶,提供病灶精确的形态学特征,并准确界定肿瘤的局部浸润范围。