螺旋CT在甲状腺良恶性结节鉴别诊断中的应用

发布时间：2018-03-29 15:42

本文选题：甲状腺结节　切入点：体层摄影术　出处：《广西医科大学》2017年硕士论文

【摘要】：研究目的:分析甲状腺良、恶性结节的CT征象,探索CT在甲状腺良、恶性结节的鉴别诊断的应用价值。研究方法:回顾性分析150例甲状腺结节的CT表现及患者一般情况,包括边界、包膜、钙化、囊变、强化程度、淋巴结肿大、年龄、性别、横断面前后径与横径的比值(A/T)等,与病理结果进行对比,比较良、恶性结节间的差异性,及与甲状腺癌发生有关的因素进行logistic回归分析。研究结果:在年龄、A/T比值、结节的数量、边界、包膜、囊变及淋巴结肿大等方面,良、恶性结节的差异有统计学意义(P0.05)。无包膜和边界不清对于诊断甲状腺恶性结节的灵敏度和特异度分别为96.9%、76.9%和62.4%、51.8%,阳性预测值和阴性预测值分别为66.3%、54.9%和96.4%、74.6%。在平扫及增强各期中,良、恶性及正常甲状腺结节CT值的差别有统计学意义(P0.05)。Logistic多因素回归分析表明无包膜,淋巴结肿大及A/T比值增大与甲状腺癌的发生独立相关。研究结论:CT扫描对于甲状腺良、恶性结节的鉴别诊断有一定价值及可行性。年龄、A/T比值、病灶数量、边缘、包膜、囊变及淋巴结肿大因素在不同性质结节中存在差异,无包膜、边界不清、无囊变、淋巴结肿大及单发病灶等征象提示恶性可能性大。
[Abstract]:Objective: to analyze the CT features of benign and malignant thyroid nodules and to explore the value of CT in the differential diagnosis of benign and malignant thyroid nodules. These include boundary, capsule, calcification, cystic degeneration, degree of enhancement, enlarged lymph nodes, age, sex, ratio of anterior and posterior diameter of cross section to transverse diameter (A / T) and so on. The difference between benign and malignant nodules was compared with pathological results. Logistic regression analysis was used to analyze the factors related to thyroid carcinogenesis. The results showed that the age ratio of A / T, the number of nodules, the number of nodules, the capsule, cysts and lymphadenopathy were good. The sensitivity and specificity for the diagnosis of malignant thyroid nodule were 96.999% and 62.4%, respectively. The positive predictive value and negative predictive value were 66.3% and 96.44.6.The positive predictive value and negative predictive value were 66.3% and 96.44.60.The sensitivity and specificity for the diagnosis of malignant thyroid nodule were 96.9% and 62.4%, respectively. The positive predictive value and negative predictive value were 54.9% and 96.44.6.The positive predictive value and negative predictive value were 66.3% and 96.44.6.The positive predictive value and negative predictive value were 66.3% and 96.4%, respectively. The difference of CT value between malignant and normal thyroid nodules was statistically significant (P 0.05). Logistic multivariate regression analysis showed that there was no capsule, lymph node enlargement and the increase of A / T ratio were independent of the occurrence of thyroid carcinoma. The differential diagnosis of malignant nodules has certain value and feasibility. There are differences in the factors of age, A / T ratio, number of lesions, margin, capsule, cystic and lymphadenopathy in different types of nodules, no capsule, unclear boundary, no cystic change. Signs of lymphadenopathy and single lesions suggest that malignancy is more likely.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1;R730.44;R581

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