甲状腺恶性肿瘤CT诊断与临床触诊的对比研究  

Comparison study of CT and physical palpation in diagnosis of thyroid carcinoma

作　　者：陈清勇[1] 吴玉泉[1] 杨胜 任志达[2] 李蓉芬[2] 

机构地区：[1]解放军117医院放射科,浙江杭州310013 [2]浙江大学医学院附属二院,浙江杭州310009

出　　处：《中国临床医学影像杂志》2001年第3期158-161,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：评价ＣＴ和临床触诊对甲状腺恶性肿瘤的诊断价值。方法：３０例甲状腺恶性肿瘤术前均进行 ＣＴ扫描和临床触诊检查，双盲法观察及分析影像所见，将其结果用卡方检验做统计学处理。结果：３０例甲状腺恶性肿瘤中ＣＴ和触诊的确诊率分别为 ８０％和 ４３． ３％。ＣＴ可确诊１１例经触诊无法明确的病变，经统计学分析，有显著性差异（Ｘ２＝ ４． ２３，Ｐ＜０．０５）。ＣＴ能准确显示肿瘤向周围结构侵犯；在诊断颈部转移性淋巴结的价值上，ＣＴ的敏感性、特异性和准确性均优于临床触诊（Ｐ＜０．０５）。结论：ＣＴ对甲状腺恶性肿瘤的术前定性诊断有较大的价值。ＣＴ在显示肿瘤向周围结构侵犯和局部淋巴结转移上明显优于临床触诊。同时联合多种诊断技术和综合分析对甲状腺恶性肿瘤的定性诊断、术式选择及预后具有重要的意义。Objective: To evaluate the value of CT and physical palpation in the diagnosis of thyroid carcinoma. Methods: Thirty cases with thyroid carcinoma were studied double blindly by CT scan and palpation preoperatively. The results were correlated with pathologic findings and X2 test was used for statistical analysis. Results: The diagnostic rate of CT scan and palpation in thyroid carci- noma were 80% and 43. 3% respectively. In 11 cases CT discovered the mass, but was found negative by palpation. By comparison, there was a significant difference on diagnostic rate between the two groups(X2= 4. 23, P<0. 05). CT accurately showed tumor spread to the surrounding structures. The sensitivity, specificity and accuracy of CT was superior to those of palpation in ascertaining cervical lymph node metastasis, there were significant differencs statistically(p<0. 05). Conclusion: CT scan had a significant value in differen- tial diagnosis in thyroid carcinoma. CT was superior to palpation in showing tumor spread to the surrounding structures and ascertaining certvical lymph node metastasis. Combined multiple imaging technology and analysis had a significant value in diagnosis, therapy plan- ning and prognosis of thyroid carcinoma.

关 键 词：甲状腺肿瘤 触诊 体层摄影术 X线计算机 诊断 对比研究 

分 类 号：R736.104[医药卫生—肿瘤]