摘要
目的回顾分析颈部非甲状腺肿物（NTMN）CT表现及其诊断价值。方法分析有完整临床和增强CT资料的NTMN患者264例CT表现及诊断良、恶性的价值，良性病变159例（60．2％），恶性105例（39．8％），淋巴结病变111例（42．0％），非淋巴结病变153例（58．O％）。应用低密度区CT值、低密度区强化比值、病变边缘、病变形态、性别、是否多发及是否为淋巴结病变7个指标分析其诊断NTMN的敏感度、特异度。分类资料用Fisher精确概率法或x2检验。结果单独应用低密度区CT值、低密度区强化比值、病变边缘、病变形态4个影像学诊断指标及性别、病变数目、是否为淋巴结病变等3个诊断指标，诊断肿物良、恶性的敏感度分别为77．1％（81／105）、81．9％（86／105）、71．4％（75／105）、56．2％（59／105）、64．8％（68／105）、75．2％（79／105）、82．9％（87／105），特异度是分别为50．9％（81／159）、44．7％（71／159）、73．0％（116／159）、67．3％（107／159）、51．6％（82／159）、73．0％（116／159）、84．9％（135／159）。联合7个诊断指标，出现4个及4个以上指标时诊断恶性的敏感度为86．7％（91／105）、特异度为74．8％（119／159）。在特殊征象中斑驳状高密度影多见于神经鞘瘤（P=0．000，25／41），规则钙化灶多见于血管瘤（P=0．000，7／18），颈动脉分又处肿物多为颈动脉体瘤（P=0．000，23／24），椎旁病变多为神经源性病变（P=0．001，9／50）。结论联合应用诊断指标和征象可提高NTMN良、恶性诊断准确率，病变位置及一些特征性表现有助于明确诊断。
Objectives To evaluate the value of computed tomography （CT） features of non-thyroidal masses of the neck （NTMN）. Methods The clinical data of 264 patients with NTMN proved by histology from 2005 to 2010 in our hospital were collected retrospectively. Among them, benign lesions were found in 159 patients （60. 2% ） , malignant ones in 105 patients （39. 8% ） , and in lymphadenopathy in 111 patients （42. 0% ） , non-lymphadenopathy in 153 patients（58.0% ）. The CT features including low- density areas, low-density areas of enhancement ratio, the edge of lesion, lesion morphology and the clinical baselines including the sex, single or multiple lesions, lymphadenopathy or non lymphadenopathy were compared for appreciating the sensitivity and specificity of the diagnosis. Categorical variables were tested with the X2 or Fisher exact tests. Results Independently using each of those four radiological signs （CT value of low density area, the enhancement ratio of low density area, border and morphology of lesion） and three clinical indexes （sex, single or multiple, lymphadenopathy or non lymphadenopathy） to diagnose the malignant tumors, the sensitivity and specificity were 77. 1% （ 81/105 ）, 81.9% （ 86/105 ） , 71.4% （75/105）,56.2% （59/105）, 64. 8% （68/105）,75.2% （79/105）,82.9% （87/105） and 50. 9% （81/159）,44.7% （71/159）, 73.0% （116/159）, 67.3% （107/159）, 51.6% （82/159）, 73.0% （116/159） ,84. 9% （135/159） respectively. When four or more signs were showed, the sensitivity and specificity were 86. 7% （91/105） and 74. 8% （ 119/159 ） respectively. The special CT features were included mottled high density sign in sehwannoma （ P = 0. 000, 25/41 ） and regular calcification in hemangioma（P = 0. 000,7/18）. Carotid body tumor was often occurred at carotid artery （P = 0. 000, 23/24）, and the most of mass of paravertebral was neurogenic tumor （ P = 0. 001,9/50）. Conclusions The diagnosis of NTMN can be improved by combining CT
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第1期23-27,共5页
Chinese Journal of Radiology
