摘要
目的探讨结节性甲状腺肿合并甲状腺癌诊断中超声联合CT的应用价值。方法2016年1月—2018年12月选择539例结节性甲状腺肿患者,所有患者均于该院接受治疗,为其开展超声和CT检查,研究结节性甲状腺肿合并甲状腺癌诊断中超声联合CT的应用价值。结果该研究共选择结节性甲状腺肿患者539例,其中90例患者经手术病理证实发生癌变,为甲状腺肿伴甲状腺癌,癌变率12.2%。乳头状癌、滤泡状癌、未分化癌、髓样癌各50例、24例、10例、6例。病灶分布方面,位于结节性甲状腺肿内、独立于结节性甲状腺肿分别为24例、66例,独立于结节性甲状腺肿患者位于右叶26例,位于左叶40例。诊断准确度方面超声为72.0%、CT为69.3%、联合检查为87.5%;诊断特异度方面超声为71.5%、CT为70.0%、联合检查为86.7%;诊断灵敏度方面超声为75.6%、CT为64.4%、联合检查为91.1%。超声表现为囊肿形态不规则、边缘不清,后方回声衰减,L/T≥1,囊肿内低回声伴不均,囊肿内及周围血管丰富、多为Ⅱ、Ⅲ级血流。CT平扫中表现为形态不规则,包膜中断低密度结节,可见斑片状、细颗粒状钙化灶,增强扫描后呈不均匀强化,可见相对低密度区。结论在甲状腺肿合并甲状腺癌诊断中超声联合CT准确度更高,可明显减少误诊和漏诊情况,具有较高推广价值。
Objective To investigate the value of ultrasound combined with CT in the diagnosis of nodular goiter and thyroid cancer. Methods From January 2016 to December 2018, 539 patients with nodular goiter were selected. All patients were treated in the hospital for ultrasound and CT. The ultrasound combined with the diagnosis of nodular goiter and thyroid cancer of the application value of CTwas studied. Results A total of 539 patients with nodular goiter were selected in this study. Among them, 90 patients were confirmed to have cancerous changes by surgery and pathology. They were thyroid with thyroid cancer and the cancer rate was 12.2%. Papillary carcinoma, follicular carcinoma,undifferentiated carcinoma, and medullary carcinoma were 50 cases, 24 cases, 10 cases, and 6 cases, respectively. In terms of lesion distribution, there were 24 cases and 66 cases in the nodular goiter, which were independent of nodular goiter. The patients were independent of nodular goiter and 26 cases were located in the right lobe and 40 cases in the left lobe. In terms of diagnostic accuracy, ultrasound was 72.0%, CT was 69.3%, and joint examination was 87.5%;diagnostic specificity was 71.5% for ultrasound, 70.0% for CT, and 86.7% for joint examination;ultrasound was 75.6%for diagnostic sensitivity, CT was 64.4%, joint inspection was 91.1%. Ultrasound showed irregular cyst shape, unclear edge, posterior echo attenuation, L/T ≥1, low echo in the cyst with unevenness, abundant cysts and peripheral blood vessels, mostly grade II and III blood flow. CT plain scan showed irregular shape, and the capsule interrupted low-density nodules. Patchy and fine-grained calcifications were observed. The enhanced enhancement showed uneven enhancement after scanning, showing relatively low-density areas. Conclusion The accuracy of ultrasound combined with CT in the diagnosis of goiter and thyroid cancer is higher, which can significantly reduce the misdiagnosis and missed diagnosis, and has a high promotion value.
作者
张月强
ZHANG Yue-qiang(Department of Radiology,Liaocheng Guangming Eye Hospital,Liaocheng,Shandong Province,252000 China)
出处
《系统医学》
2019年第21期16-18,共3页
Systems Medicine
