Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Computed Tomography Features of Follicular Thyroid Carcinoma: Comparison with Papillary Thyroid Carcinoma

소포갑상선암종의 전산화단층촬영 소견: 유두갑상선암종과의 비교

  • Lee, Hyung-Geun (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Choi, Yoon-Jung (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chung, Eun-Chul (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 이형근 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 최윤정 (성균관대학교 의과대학 강북삼성병원 영상의학과) ;
  • 정은철 (성균관대학교 의과대학 강북삼성병원 영상의학과)
  • Published : 2011.01.01
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Abstract

Purpose: The purpose of this study is to analyze the computed tomography (CT) features of follicular thyroid carcinoma (FTC) as compared to those of papillary thyroid carcinoma (PTC) to identify the characteristic imaging features of FTC. Materials and Methods: The following CT features were analyzed to compare FTCs (n = 17) and PTCs (n = 27): size, shape, margin, internal composition, calcification, enhancement homogeniety, extrathyroidal extension, lymph node (LN) metastasis and the density and degree of enhancement (qualitatively and quantitatively). Results: There were no significant differences between the patients with FTCs and those with PTCs with respect to age and gender, and the internal composition, calcification and enhancement homogeneity of the tumor. However, the FTCs tend to show a larger size (32 mm vs. 15 mm; respectively, p < 0.001), a round to oval shape (52.9% vs. 14.8% respectively, p = 0.001), a well-defined smooth margin (58.8% vs. 14.8% respectively, p = 0.009), less extrathyroidal extension (11.8% vs. 51.9% respectively, p= 0.007) and less LN metastasis (0% vs. 29.6% respectively, p = 0.016) compared to that of the PTCs. Furthermore, the FTCs showed significantly stronger enhancement in the early phase (146.4${\pm}$42.4 vs. 98.5${\pm}$38.2 respectively, p < 0.001) and a greater decrement of the late enhancement (-44.6${\pm}$25.2 vs. -18.7${\pm}$27.9 respectively, p = 0.003) compared to that of the PTCs. Conclusion: FTCs had a tendency to be observed on neck CT as well-defined, smooth, round to oval nodules with strong early enhancement and a definite decrement of late enhancement as compared to the PTCs.

목적: 본 연구는 소포갑상선암종과 유두갑상선암종의 전산화단층촬영 소견을 비교 분석하여 소포갑상선암종에서 주로 보이는 특징적 영상소견을 알아보고자 하였다. 대상과 방법: Neck CT에서 소포갑상선암종 (n=17)과 유두갑상선암종 (n=27)의 크기, 모양, 경계, 내부 성상, 석회화, 조영증강의 균일성, 갑상선외 조직침윤과 림프절 전이를 비교 분석하였고, nodule의 밀도와 조영증강 정도에 대해서도 정성적, 정량적으로 비교 분석하였다. 결과: 나이, 성별, 내부 성상, 석회화와 조영증강의 균일성에는 소포갑상선암종과 유두갑상선암종으로 진단된 환자에서 통계적으로 의미있는 차이를 보이지 않았다. 그러나 소포갑상선암종은 유두갑상선암종과 비교하여 크기가 더 크고 (32 mm vs. 15 mm; p < 0.001), 원형 또는 난형의 모양(52.9% vs. 14.8%; p = 0.001)과 분명하고 매끈한 경계 (58.8% vs. 14.8%; p = 0.009)를 좀 더 보였으며, 갑상선외 조직침윤 (11.8% vs. 51.9%; p = 0.007)과 림프절 전이 (0% vs. 29.6%; p = 0.016)는 덜 되는 양상이었다. 그 뿐만 아니라 소포갑상선암종은 초반 (early phase)의 강한 조영증강 (146.4 ${\pm}$ 42.4 vs. 98.5 ${\pm}$ 38.2; p < 0.001)과 후반 조영증강 (late enhancement)의 뚜렷한 감소(-44.6 ${\pm}$ 25.2 vs. -18.7 ${\pm}$ 27.9; p = 0.003)를 보여 유두갑상선암종과 비교하여 의미있는 차이를 보였다. 결론: Neck CT에서 소포갑상선암종는 유두갑상선암종과 비교하여 초반 (early phase)의 강한 조영증강과 후반 조영증강 (late enhancement)의 뚜렷한 감소를 보이며, 분명하고 매끈한 경계를 갖는 원형 또는 난형의 nodule로 보이는 경향이 있다.

Keywords

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