摘要
目的:探讨双能量CT联合超声鉴别甲状腺良恶性结节的价值。方法:回顾性分析本院经病理证实且行双能量CT静脉期增强扫描及超声检查的90个甲状腺结节(乳头状癌63个,结节性甲状腺肿27个),计算标准化碘值(NIC),记录结节CT形态学及超声表现,比较两组结节的NIC,评价NIC、超声、CT形态学独立诊断及联合诊断的效能。结果:甲状腺乳头状癌、结节性甲状腺肿的NIC平均值为0.32±0.33、0.77±0.16(P<0.05),当NIC以0.65为阈值时,预测甲状腺恶性结节的曲线下面积(AUC)为0.92,NIC、超声、CT形态学独立诊断的敏感度为85.20%、76.19%、73.81%,特异度为88.90%、66.67%、77.78%,符合率为80%、76.67%、73.33%。三者联合诊断的敏感度为82.50%,特异度为92.60%,符合率为84.44%。结论:双能量CT静脉期增强NIC及CT形态学联合超声检查能提高甲状腺结节的诊断准确性。
Objective:To investigate the value of dual-energy computed tomography combined with ultrasound in distinguishing the benign and malignant thyroid nodules.Methods:Patients with a total of 90 pathology proven thyroid nodules(63 papillary carcinoma,27 nodular goiter)underwent dual energy CT enhanced scanning and ultrasound examination.We calculated normalized iodine concentration(NIC)of the thyroid nodules in venous phase and recorded the CT morphology and ultrasound examination results.The receiver operating characteristic(ROC)curves were utilized to select the critical value of the optimum sensitivity and specificity,and its independent and combined value were compared.Results:The NIC of malignant nodules were 0.32±0.33,which was lower than those of benign nodules 0.77±0.16(P<0.05).When using NIC of 0.65 to differentiate malignant thyroid nodules,the ROC curves showed that the area under the curve(AUC)was 0.92 in venous phase.The independent(NIC,CT morphology,ultrasound examination)and combined sensitivity was 85.20%,76.19%,73.81%,82.50%.The specificity was 88.90%、66.67%、77.78%、92.60%,the accuracy was 80%、76.67%、73.33%、84.44%.Conclusion:The NIC in venous phase with dual-energy CT scanning combining morphology and ultrasound examination of nodules can differentiate malignant from benign thyroid nodules.
作者
刘妮
王淑霞
谢元亮
黄增发
王翔
LIU Ni;WANG Shu-xia;XIE Yuan-liang(Department of Radiology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)
出处
《放射学实践》
北大核心
2019年第11期1224-1227,共4页
Radiologic Practice
基金
武汉市卫计委基金资助项目(WX10D03)
关键词
甲状腺结节
碘浓度
体层摄影术
X线计算机
超声
Thyroid nodule
Iodine concentration
Tomography
X-ray computed
Ultrasound
