摘要
目的分析甲状腺结节的CT征象特征及动态强化CT值变化,探讨其临床诊断价值。方法选择2014年5月—2016年5月在上海市金山区亭林医院诊治的经病理证实甲状腺结节患者188例(309个结节)的资料,进行回顾性分析CT征象的诊断价值。结果188例甲状腺结节患者(309个结节)确诊为良性者138例(73.40%),其中甲状腺腺瘤39例(28.26%),结节性甲状腺肿99例(71.74%);恶性者50例(26.60%)。微小钙化、包膜、囊变、边界、淋巴结肿大、强化环中断各CT征象在3种甲状腺结节病变中比较差异有统计学意义(P<0.05),而甲状腺癌与甲状腺腺瘤及结节性甲状腺肿比较(除囊变)差异有统计学意义(P<0.05)。通过参考强化环中断指标估算甲状腺癌的敏感度、阴性预测值较高,淋巴结肿大指标估算甲状腺腺瘤的特异度、阴性预测值较高,微小钙化指标估算结节性甲状腺肿的特异度、阴性预测值较高。同时强化环中断和淋巴结肿大的并联实验,其敏感度、阴性预测值较明显提高。结论采用微小钙化、淋巴结肿大、强化环中断及其并联的各CT征象需综合分析鉴别甲状腺癌、甲状腺腺瘤或结节性甲状腺肿,显示出各征象的敏感度、特异性及局限性,但对甲状腺腺瘤、结节性甲状腺肿的鉴别尚需进一步研究。
Objective To analyze the CT features of thyroid nodules and dynamic CT value changes to explore its clinical value. Methods The data of 188 pathologically confirmed thyroid nodules（ 309 nodules） from May 2014 to May 2016 in our hospital were retrospectively analyzed for the diagnostic value of CT findings. Results Patients of thyroid nodules（ 309 nodules） were diagnosed as benign in 138 cases（ 73. 40%）,of which 39 patients were thyroid adenoma（ 28. 26%）,99 patients were nodular goiter（ 71. 74%）,and 50 patients were malignant（ 26. 60%）. Microcalcification,capsule,cystic degeneration,borderline,lymph node enlargement,enhanced ring break CT signs in the three thyroid nodules were compared（ P〈 0. 05）,and thyroid cancer and thyroid adenoma and nodular goiter comparison（ Except cystic change）（ P〈 0. 05）. The sensitivity of thyroid cancer was estimated by referring to the enhanced ring disruption index,the negative predictive value was higher,the specificity of lymph node enlargement index was estimated,the negative predictive value was higher,the specificity of microcalcification index was to estimate the specificity of thyroid nodular goiter,negative predictive value is higher. At the same time strengthen the ring cut and lymph node enlargement in parallel experiments, the sensitivity, negative predictive value were significantly improved.Conclusion The use of microcalcification,enlarged lymph nodes,enhanced ring disruption and parallel CT scans for differential diagnosis of thyroid cancer,thyroid adenoma or nodular goiter suggests sensitivity,specificity and limitations for each sign,but the thyroid adenoma,nodular goiter to identify need further study.
作者
何俊林
王永胜
蔡剑波
王晨思
洪瑶
HE Jun-lin;WANG Yong-shen;CAI Jian-bo;WANG Chen-Si;HONG Yao(Shanghai Jinshan District Tinglin Hospital,Shanghai 201505 ~ China)
出处
《医药论坛杂志》
2018年第7期17-20,共4页
Journal of Medical Forum
基金
上海市金山区卫计委科研基金项目资助(JSKJ KTMS201512)
