超声造影联合CT检查对甲状腺良恶性结节的鉴别诊断研究  

Differential diagnosis of benign and malignant thyroid nodules by contrast-enhanced ultrasound combined with CT

作　　者：吴明[1] 张欣玉 石锋[1] 舒松[1] WU Ming;ZHANG Xinyu;SHI Feng(First People’s Hospital of Tianmen City,Hubei Province,Tianmen 431700)

机构地区：[1]湖北省天门市第一人民医院,天门431700

出　　处：《陕西医学杂志》2020年第3期333-336,共4页Shaanxi Medical Journal

摘　　要：目的:分析超声造影及CT检查在甲状腺良恶性结节临床鉴别诊断中的应用价值。方法:选择甲状腺结节患者105例,均进行超声造影及CT检查,将病理检查结果作为"金标准",对单独CT检查、超声造影检查、CT联合超声造影检查准确性、特异性、敏感性差异进行分析。结果:105例患者病理检查结果显示,甲状腺良性结节患者共81例(77.14%),其中甲状腺瘤18例(17.14%),结节性甲状腺肿54例(51.43%),桥本氏甲状腺炎9例(8.57%);甲状腺恶性结节共24例(22.86%),其中乳头状癌15例(14.29%),髓样癌3例(2.86%),滤泡状癌6例(5.71%);超声造影联合CT诊断准确性、特异性及敏感性均显著高于单独CT检查与单独超声造影检查(P<0.05)。结论:甲状腺良恶性结节临床鉴别诊断中CT与超声造影联合使用可有效提高诊断准确性,且联合诊断方式对患者无创伤性,检查安全性较高,患者耐受性较好,对降低误诊与漏诊情况的发生、提高诊断效率均具有重要意义。Objective:To analyze the value of contrast-enhanced ultrasound and CT in the differential diagnosis of benign and malignant thyroid nodules.Methods:105 patients with thyroid nodules were enrolled in the study.All patients underwent contrast-enhanced ultrasound and CT examinations after admission.The results of pathological examinations were regarded as the"gold standard".The differences in accuracy,specificity and sensitivity of CT examination,contrast-enhanced ultrasound and CT with combined contrast-enhanced ultrasound were analyzed.Results:There were 81 patients with benign thyroid nodules(77.14%),including 18 cases of thyroid tumors(17.14%),54 cases of nodular goiter(51.43%),and 9 cases of Hashimoto’s thyroiditis(8.57%).There were 24 patients with thyroid malignant nodules(22.86%),including 15 cases of papillary carcinoma(14.29%),3 cases of medullary carcinoma(2.86%),and 6 cases of follicular carcinoma(5.71%).The accuracy,specificity and sensitivity of contrastenhanced ultrasound combined with CT were significantly higher than those of CT and contrast-enhanced ultrasound alone(P<0.05).Conclusion:The combination of CT and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant thyroid nodules can effectively improve the diagnostic accuracy.The combined diagnosis method is non-invasive for patients,has higher inspection safety and better patient tolerance.It is of great significance to reduce the occurrence of misdiagnosis and missed diagnosis and improve the diagnosis efficiency.

关 键 词：CT 超声造影 甲状腺结节 癌 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]