Takashima S, Morimoto S, Ikezoe J, Takai S, Kobayashi T, Koyama H, Nishiyama K, Kozuka T
Department of Radiology, Osaka University Medical School, Japan.
AJR Am J Roentgenol. 1990 May;154(5):1079-85. doi: 10.2214/ajr.154.5.2108546.
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检查结果与病理检查结果及触诊结果进行了回顾性比较。58%的患者中，癌表现为低密度大肿块伴致密钙化；74%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。7例患者（50%）有坏死性淋巴结。CT在检测1例患者的原发肿瘤及7例患者的转移淋巴结方面优于触诊。它为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例甲状腺肿瘤有胸内延伸及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及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，它在手术规划中是不可或缺的。
