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| The pathological basis of nodular goiter and correlative with specific signs of spiral CT |
| HU Yan-biao1, SU Ming-jin1, XIAO Wei-hua1, FU Feng2 |
| 1. Department of Radiology, Beilun People’s Hospital, Ningbo Zhejiang 315806, China;2. Department of Radiology, Ningbo Medcial Center LI Hui-li Hospital, Ningbo Zhejiang 315040, China |
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Abstract Objective: To analyse the specific characteristics spiral CT signs of nodular goiter in order to improve its diagnostic accuracy. Methods: Sixty cases confirmed surgically and pathologically to be nodular goiter which were found by preoperative spiral CT scans plus three phase enhanced scans, 1 case was found by cervical disc CT scan, 4 cases were found by chest CT examination. CT signs were observed, and correlated with pathological findings. Diagnostic criteria and differential points were advocated. Results: ①Site, number, size and density of lesions: no lesion protrudes beyond the thyroid capsule, multiple lesions in 43 cases, single in 17 cases, the size of single lesion was larger than that of the multiple lesions with an average of 3.5cm, mostly cystic; mixed density mostly low in 32 cases, high density in 11 cases. ②Pathological types: Forty-nine cases were diagnosed as nodular goiter pathologically, including nodular goiter with papillary hyperplasia or adenomatous nodules in 18 cases, nodular goiter with adenoma in 7 cases, nodular goiter with papillary carcinoma in 4 cases. ③Characteristics of spiral CT: multiple lesions were more common, mixed dominantly low in density, garland-like; patchy; or homogeneously high density in 11 cases. Calcification seen in 31 cases; septations within lesion in 15 cases; capsule were seen in 24 cases; various degree of cystic formation in 49 cases in which completely cystic changes in 12 cases. On enhanced scan, 22 cases showed multiple papillary enhancement, filling enhangcement seen in 32 cases on balanced phase; various size of slit like low density within the cystic area; isodensity on the balanced phase in 26 cases. Conclusion: Specific CT signs of nodular goiter include well defined margin of thyroid; multiple papillary enhanced nodules on contrast scan; homogeneous filling density on balanced phase; central slit-like low density; morpholy and distribution of calcification; septation within lesion; smooth small round cystic area within lesion. These spectific signs have important diagnostic value.
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Received: 29 November 2010
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2011, Vol. 22 
