双源CT碘图与能谱曲线技术在甲状腺结节鉴别诊断中的应用  

Application of dual-source CT iodine map and energy spectrum curve technique in differential diagnosis of thyroid nodule

作　　者：金梅[1] 刘力[1] 林奕军 高振兴[1] 陈通[1] 侯庆更[1] 徐桂荣[1] 于晓明[1] 谷跃[1] 

机构地区：[1]黑龙江省齐齐哈尔市第一医院CT诊断室,黑龙江齐齐哈尔161005

出　　处：《医学影像学杂志》2016年第12期2203-2207,共5页Journal of Medical Imaging

基　　金：黑龙江省齐齐哈尔市科技局社会发展指导性计划项目(SFZD-2014080)

摘　　要：目的探讨双源CT碘图与能谱曲线技术在甲状腺结节鉴别诊断中的应用价值。方法回顾性分析58例经病理证实并行双能量模式(DECT)增强扫描的甲状腺结节患者的影像资料,利用"Liver VNC""Monoenergytic"软件处理得到碘图与能谱曲线,对甲状腺结节碘图和能谱曲线进行比较研究。结果良性结节的碘含量明显低于正常甲状腺组织高于恶性结节,甲状腺良恶性结节内实性成分之间的碘含量差异有统计学意义(P<0.05);良性组所有结节单能谱成像病变实性成分呈下降型曲线,与正常甲状腺组织能谱走行一致,恶性组呈上升型曲线,少部分表现下降型曲线。良性组曲线斜率在三个期相均大于恶性组,在平扫和动脉期,两组间的曲线斜率两两比较差异均有统计学意义(P<0.05);双能CT检查的灵敏度为88.5%,特异性为92.9%,准确率为96.2%。结论碘图定量分析和能谱曲线技术可提高甲状腺结节定性诊断的准确率,为甲状腺疾病临床诊疗提供新的影像学检查方法。Objective To explore the clinical utility of dual-source CT iodine map and energy spectrum curve technique which are used in differential diagnosis of thyroid nodule. Methods The radiographic data of fifty-eight cases confirmed by pathology were retrospectively analyzed in parallel normal Thyroid and Dual energy patterns （DECT） of patients with Thyroid nodule en- hancement scanning, using the iodine map and energy spectrum curve, which processed by the ＂Liver VNC＂ and ＂Monoenergytic＂. We campared the thyroid nodules iodine map and energy spectrum curve display of the lesions. Results Lodine content of the benign nodules was significantly lower than that of the normal thyroid tissue but higher than that of the malignant nodules, there was a significant difference in the contents of iodine in the solid components between bengin and malignant thyroid nodules （ P 〈 0. 05 ）. In benign group, all nodules single spectral imaging lesion solid composition showed the decline type curve, consistent with normal thyroid tissue energy spectrum contorts, an upward curve in malignant group, a small number of performance decline type curve. Benign group of curve slope in the three phase phase were greater than malignant group, in the scan and arterial, curve slope of two comparison of the differences between two groups had statistical significance （ P 〈 0.05 ）. The sensitivity of dual energy CT examination was 85.5 %, specificity was 92.9%, the accuaracy was 96.2%. Conclusion The accuracy of qualitative diagnosis of thyroid nodules improved by quantitative analysis of joint iodine map and energy spectrum curve technique has obviously provided the important information for clinical therapy of thyroid gland.

关 键 词：甲状腺结节 碘图 能谱曲线 体层摄影术 X线计算机 

分 类 号：R581[医药卫生—内分泌] R814.42[医药卫生—内科学]