CT径线比鉴别甲状腺微小癌与良性结节的价值

发布时间：2018-03-12 14:25

  本文选题：甲状腺肿瘤　切入点：甲状腺结节　出处：《中国医学影像学杂志》2015年11期 　论文类型：期刊论文

【摘要】：目的甲状腺乳头状微小癌(PTMC)术前定性诊断比较困难,容易漏诊和误诊,本文旨在探讨CT径线比鉴别诊断PTMC与良性结节的价值。资料与方法选取经手术病理证实为直径≤1.0 cm的甲状腺良恶性微小结节的78例患者共154个结节,分为PTMC组47例共75个结节和良性微小结节组31例共79个结节。测量计算横断面前后径和横径比值(A/T)、矢状面前后径和上下径比值(A/L)和冠状面上下径和横径比值(L/T),绘制A/T、A/L和L/T诊断PTMC的ROC曲线,比较其曲线下面积,计算CT径线比诊断PTMC的灵敏度、特异度、准确度、阳性预测值及阴性预测值。比较两组CT征象及其诊断PTMC的准确率。结果 PTMC组的A/T、A/L显著大于良性结节组(P0.01),L/T小于良性结节组(P0.01)。A/T、A/L和L/T ROC曲线下面积分别为0.8841、0.7676和0.4052,A/T和A/L的最佳诊断界值为1.05和1.0,A/T≥1.05诊断PTMC的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为88.00%%、84.81%、86.36%、84.62%和88.12%,A/L≥1.0诊断PTMC的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为66.67%、82.28%、74.68%、78.13%和72.22%。PTMC组CT征象:结节位于腺体表浅部位、类圆形低密度、边界模糊不清、结节内细颗粒钙化和渐进性填充式强化诊断PTMC的准确度分别为71.43%、50.00%、79.22%、68.83%和90.91%。结论 CT径线比对诊断PTMC有较高的价值,A/T≥1.05、A/L≥1.0可以作为CT诊断PTMC的重要指标。
[Abstract]:Objective it is difficult to diagnose papillary thyroid carcinoma with PTMC before operation, and it is easy to miss diagnosis and misdiagnosis. The purpose of this study was to investigate the value of CT line ratio in the differential diagnosis of PTMC and benign nodules. Materials and methods A total of 154 nodules were selected from 78 patients with benign and malignant thyroid nodules whose diameters were less than 1.0 cm proved by surgery and pathology. There were 47 cases with 75 nodules in PTMC group and 31 cases with benign micronodule group. The ratio of anteroposterior diameter and transverse diameter of cross section was measured and calculated. The ratio of anterior and lower sagittal diameter to inferior diameter of sagittal plane and the ratio of upper and lower diameter to transverse diameter of coronal plane were measured and calculated, and the ratio of upper and lower diameter to transverse diameter of coronal plane was plotted. To make a ROC curve for the diagnosis of PTMC by A / T / A / L / L / T, The area under the curve was compared, and the sensitivity, specificity and accuracy of computed tomography (CT) ratio in diagnosing PTMC were calculated. The positive predictive value and the negative predictive value were compared between the two groups. The CT signs and the diagnostic accuracy of PTMC were compared between the two groups. Results the area under the ROC curve in PTMC group was 0.8841 0.7676 and 0.4052 A / L, respectively, which was significantly higher than that in benign nodule group (P 0.01 / L / L) than that in benign nodule group (P < 0.01). The area under the curve was 0.88410.7676 and 0.4052A / T and A / L, respectively. The best diagnostic cutoff values were 1. 05 and 1. 0 A / T 鈮，

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