双能CT诊断颈部中央区甲状腺乳头状癌小淋巴结转移

发布时间：2018-01-24 02:03

本文关键词： 体层摄影术 X线计算机碘浓度甲状腺肿瘤淋巴结　出处：《中国医学影像技术》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨双能量CT对甲状腺乳头状癌在颈部中央区小淋巴结转移的诊断价值。方法回顾性分析经病理证实为甲状腺乳头状癌且术前接受双能量CT增强扫描的43例患者资料。比较甲状腺乳头状癌转移淋巴结组及非甲状腺乳头状癌转移淋巴结组淋巴结的短径、动脉期及静脉期碘浓度、标准化碘浓度(NIC)、能谱曲线斜率。绘制ROC曲线,分析应用碘浓度及NIC对甲状腺癌转移淋巴结的诊断效能。结果 43例患者共119枚淋巴结,其中转移淋巴结55枚、非转移淋巴结64枚。2组淋巴结短径差异有统计学意义(t=-2.20,P=0.03)。动脉期转移淋巴结组及非转移淋巴结组碘浓度分别为(2.93±1.62)mg/ml及(2.17±1.09)mg/ml,NIC分别为0.33±0.21及0.19±0.12,曲线斜率分别为0.79±0.43及0.63±0.37。静脉期甲状腺乳头状癌转移淋巴结组及非甲状腺乳头状癌转移淋巴结组碘浓度分别为(2.68±1.54)mg/ml及(2.17±1.01)mg/ml,NIC分别为0.51±0.18及0.43±0.15,曲线斜率分别为0.54±0.42及0.62±0.39。2组间动脉期及静脉期碘浓度、NIC、动脉期曲线斜率差异均有统计学意义(P均0.05)。ROC曲线分析显示,动脉期碘浓度、NIC诊断甲状腺癌转移淋巴结的曲线下面积(AUC)分别为0.62、0.73,静脉期碘浓度、NIC分别为0.61、0.63。结论双能CT动脉期及静脉期碘浓度、NIC及动脉期曲线斜率在不同性质的中央区小淋巴结间存在差异,双能量CT有助于鉴别中央区转移及非转移小淋巴结。
[Abstract]:Objective to evaluate the diagnostic value of dual-energy CT in the diagnosis of small lymph node metastasis of papillary thyroid carcinoma in the central region of the neck. The data of 43 patients were compared between metastatic lymph nodes of papillary thyroid carcinoma and metastatic lymph nodes of non-thyroid papillary carcinoma. Iodine concentration in arterial phase and venous phase, standardized iodine concentration, slope of energy spectrum curve, ROC curve were plotted. The efficacy of iodine concentration and NIC in the diagnosis of metastatic lymph nodes in thyroid cancer was analyzed. Results there were 119 lymph nodes in 43 patients, 55 of which were metastatic lymph nodes. There was significant difference in the short diameter of lymph nodes between 64 non-metastatic lymph nodes (n = 64) and non-metastatic lymph nodes (n = 64). The iodine concentrations in metastatic lymph node group and non-metastatic lymph node group were 2.93 卤1.62mg / ml and 2.17 卤1.09mg / ml, respectively. NIC was 0.33 卤0.21 and 0.19 卤0.12, respectively. The curve slope was 0.79 卤0.43 and 0.63 卤0.37.The iodine concentrations in metastatic lymph nodes of papillary thyroid carcinoma and non-papillary thyroid carcinoma were (. 2.68 卤1.54 mg / ml and 2.17 卤1.01g / ml respectively. NIC was 0.51 卤0.18 and 0.43 卤0.15, and the curve slope was 0.54 卤0.42 and 0.62 卤0.39.2, respectively. The difference of slope of arterial phase curve was statistically significant (P < 0.05). ROC curve analysis showed that iodine concentration in arterial phase was higher than that in control group (P < 0.05). The area under the curve of NIC in diagnosing metastatic lymph nodes of thyroid carcinoma was 0.62n 0.73, and the iodine concentration in venous phase was 0.61. Conclusion the iodine concentration in arterial phase and venous phase and the slope of arterial phase curve are different among the small lymph nodes in the central region with different characteristics. [WT5HZ] [WT5 "HZ] [WT5" BZ] [WT5 "BZ]. Dual-energy CT is helpful in differentiating small lymph nodes from metastatic and non-metastatic lymph nodes in the central region.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【基金】：云南省卫生科技计划项目(2014NS158)
【分类号】：R730.44;R736.1
【正文快照】： 甲状腺癌是内分泌系统最常见的恶性肿瘤,约占恶性肿瘤的1%~2%,多发于青壮年,女性发病率高于男性[1]。其主要组织学类型可分为乳头状癌、滤泡状癌、髓样癌和未分化癌,临床以乳头状癌最常见。乳头状癌的预后较好,但仍有一定侵袭性,颈淋巴结转移是乳头状癌最主要的转移方式[2]。

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