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目的探讨亚急性甲状腺炎(SAT)的CT表现,以提高对其认识。方法回顾性分析23例SAT患者的CT影像特征及临床相关资料,所有病例均经手术病理或穿刺活检证实。结果依病变形态分为局限型、弥漫型、混合型。23例中,局限型16例,病变局限发生于单叶或双叶或单叶加峡部,按病变数目又分为单灶型6例和多灶型10例;弥漫型5例,指病变同时浸润左右叶及峡部;混合型即局限与弥漫型并存2例。病灶均表现为边缘模糊不清,呈片状、结节状或不规则阴影,平扫密度低于邻近肌肉,增强后病变呈明显或轻度不均匀强化,病变一般无明显占位效应,其中混合型表现为单叶加峡部弥漫浸润为主,病变向对侧叶过渡,间以对侧叶局限灶散在。23例中发现“过渡征”5例及甲状腺“岛征”4例,7例病变甲状腺包膜不连续,2例合并有颈部淋巴结增大。23例均可触及甲状腺不同程度肿大,12例伴有颈前区压痛,5例实验室检查血FT3、FT4升高的同时131I摄取率下降。结论 SAT的CT表现具有一定特征,患者临床表现、实验室检查亦非常重要,综合考虑有助于提高诊断准确率。
Objective To investigate the CT findings of subacute thyroiditis (SAT) in order to improve its understanding. Methods The CT features and clinical data of 23 patients with SAT were retrospectively analyzed. All cases were confirmed by pathology or biopsy. Results according to the lesion is divided into limitations, diffuse, mixed type. Of the 23 cases, 16 were localized, and the lesion occurred in single or double leaves or single leaves plus isthmus. According to the number of lesions, they were further divided into 6 cases of single foci and 10 cases of multifocal; 5 cases of diffuse lesions Infiltration of left and right leaves and isthmus; mixed type that is confined with diffuse two cases. Lesions showed edge fuzzy, flaky, nodular or irregular shadows, plaque density lower than adjacent muscles, enhanced lesions were significantly or mildly uneven enhancement, lesions generally no significant placeholder effect, in which Mixed performance of single-leaf plus isthmus-dominated diffuse infiltration, the lesion transition to the contralateral leaves, interspersed with the limitations of the lateral lobe scattered. Among the 23 cases, 5 cases of “transition syndrome” and 4 cases of thyroid “island syndrome” were found. Thyroid capsule was discontinuous in 7 cases and enlarged with cervical lymph nodes in 2 cases. Twenty-three cases had palpable thyroid gland enlargement in varying degrees, 12 cases with tenderness in the anterior neck area, and 5 cases of laboratory examination with elevated blood FT3 and FT4 while the 131I uptake rate decreased. Conclusion The CT appearance of SAT has certain characteristics. The clinical manifestations and laboratory tests of patients are also very important. Comprehensive consideration will help to improve the diagnostic accuracy.