甲状腺常见单发结节CT多征象联合鉴别诊断

发布时间：2018-06-03 03:04

本文选题：单发甲状腺结节 + 体层摄影术　；参考：《临床放射学杂志》2016年07期

【摘要】：目的探讨甲状腺常见良、恶性单发结节的CT平扫及单期增强影像特征,应用多征象联合的方法提高鉴别诊断水平。方法搜集甲状腺单发结节患者61例(其中结节性甲状腺肿27例,腺瘤7例,甲状腺癌27例),比较分析良、恶性结节的影像征象(包括是否囊变、增强后结节与甲状腺组织的边界、钙化、甲状腺边缘腺体的完整性、增强扫描结节实性成分密度是否均匀及颈部有无异常淋巴结),进行χ~2检验及Logistic回归区分主要征象及次要征象,使用主次多征象联合方法判断结节性质。结果经χ~2检验良恶性甲状腺结节以上影像征象的差异均有统计学意义(P0.05);Logistic回归分析显示,无囊变、增强后结节与正常甲状腺组织边界不清晰及颈部异常淋巴结为甲状腺恶性结节的危险征象(OR值分别为10.672、27.188、94.000),上述3个征象作为鉴别甲状腺结节性质的主要征象,其他3个征象作为次要征象,以2个主要征象加1个次要征象或1个主要征象加3个次要征象作为诊断恶性结节的最低标准,诊断本组恶性结节敏感度为88.9%,特异度为88.2%,阳性预测值为85.7%,阴性预测值为90.9%,总体诊断符合率为88.5%。结论 CT平扫及单期增强检查对评估甲状腺常见单发结节性质具有重要价值,应用主次多征象联合判断的方法可获得较高的诊断准确率。
[Abstract]:Objective to investigate the CT features of common benign and malignant single nodule of thyroid and to improve the differential diagnosis by combining multiple signs. Methods Sixty-one patients with solitary thyroid nodules (including 27 cases of nodular goiter, 7 cases of adenoma and 27 cases of thyroid carcinoma) were collected. Enhance the boundary between the posterior nodule and the thyroid tissue, calcification, the integrity of the thyroid marginal gland, Whether the solid component density was homogeneous or not and whether there were abnormal lymph nodes in the neck were detected by contrast enhanced scanning. The main and secondary signs were distinguished by 蠂 ~ 2 test and Logistic regression. The main and secondary signs were combined with multiple signs to judge the nodular character. Results by 蠂 ~ 2 test, the difference of imaging signs above benign and malignant thyroid nodules was statistically significant (P 0.05). Logistic regression analysis showed that there was no cystic change. The OR values of the enhanced nodule and the normal thyroid tissue were not clear and the abnormal lymph nodes of the neck were thyroid malignant nodules. The OR values of these three signs were 10.672 卤27.1884.000, respectively. The above three signs were used as the main signs to distinguish the thyroid nodule from the thyroid nodule. The other 3 signs were used as secondary signs, 2 main signs plus 1 secondary sign or 1 main sign plus 3 minor signs as the minimum criteria for the diagnosis of malignant nodules. The sensitivity, specificity, positive predictive value and negative predictive value of diagnosis of malignant nodules were 88. 9, 88. 2, 85. 7 and 90.9, respectively. The overall diagnostic coincidence rate was 88. 5%. Conclusion plain CT scan and single phase contrast enhancement are important for the evaluation of common single thyroid nodules, and the diagnostic accuracy can be obtained by combining primary and secondary multiple signs.
【作者单位】：赣南医学院第一附属医院影像中心;
【基金】：江西省教育厅青年科学基金项目(编号:GJJ14701)
【分类号】：R736.1;R730.44

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