Takashima S, Morimoto S, Ikezoe J, Takai S, Kobayashi T, Koyama H, Nishiyama K, Kozuka T
Department of Radiology, Osaka University Medical School, Japan.
AJNR Am J Neuroradiol. 1990 Mar-Apr;11(2):361-7.
CT findings in 19 patients with anaplastic thyroid carcinoma were compared retrospectively with pathologic findings and the results of palpation. The carcinoma appeared as a large mass of low attenuation accompanied by dense calcification in 58% of the patients; there was necrosis in 74%. Often, adjacent structures were infiltrated. CT correctly showed tumor invasion of the carotid artery (7/7), internal jugular vein (9/10), larynx (5/6), trachea (8/10), esophagus (4/5), mediastinum (5/5), and regional lymph nodes (14/16). Seven patients (50%) had necrotic nodes. CT was superior to palpation in the detection of a primary tumor in one patient and of metastatic nodes in seven patients. It suggested a suitable place for biopsy in two patients, leading to a correct diagnosis. CT altered surgical planning in five patients with intrathoracic extension of the thyroid tumor, and in three patients with laryngeal or esophageal invasion of the tumor. CT can increase diagnostic accuracy in patients with anaplastic thyroid carcinoma by suggesting a likely diagnosis and by indicating an appropriate site for biopsy. It is indispensable in the planning of surgery for patients with this disorder.
对19例间变性甲状腺癌患者的CT表现进行回顾性分析，并与病理结果及触诊结果进行比较。58%的患者中，癌表现为低密度大肿块伴致密钙化；74%的患者存在坏死。相邻结构常受浸润。CT正确显示了颈动脉（7/7）、颈内静脉（9/10）、喉（5/6）、气管（8/10）、食管（4/5）、纵隔（5/5）及区域淋巴结（14/16）的肿瘤侵犯情况。7例患者（50%）有坏死性淋巴结。在1例患者中，CT在检测原发肿瘤方面优于触诊；在7例患者中，CT在检测转移淋巴结方面优于触诊。CT为2例患者提示了合适的活检部位，从而得出正确诊断。CT改变了5例甲状腺肿瘤胸内扩展患者及3例肿瘤侵犯喉或食管患者的手术计划。CT通过提示可能的诊断并指出合适的活检部位，可提高间变性甲状腺癌患者的诊断准确性。对于患有这种疾病的患者，CT在手术规划中是不可或缺的。
