CT灌注成像评价单发甲状腺结节及其生化指标的研究  

Evaluation of single thyroid lesion by multi-slice spiral CT perfusion imaging and its biomedical indexes

作　　者：张照涛 左敏静[1] 彭碧波[1] 刘颖[1] 严辉峰 

机构地区：[1]南昌大学第二附属医院影像科,南昌330006

出　　处：《江西医药》2017年第10期961-965,共5页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划项目;编号20131065

摘　　要：目的探讨CT灌注成像及术前甲状腺激素水平在甲状腺单发良、恶性结节诊断及鉴别诊断中的作用,并对二者进行相关性分析。方法分析经术后病理证实的单发甲状腺结节93例,其中结节性甲状腺肿48例(包括单纯型结节性甲状腺肿和腺瘤型结节性甲状腺肿),甲状腺乳头状癌28例,亚急性甲状腺炎17例;颈部平扫后选择靶平面进行灌注扫描,比较各组病变CT灌注参数值如:血容量(BV)、血流量(BF)、平均通过时间(MTT)、表面通透性(PS)和达峰时间(TTP)以及术前相关甲状腺激素水平,并对二者进行相关性分析。结果结节性甲状腺肿各灌注参数BV、BF、PS、MTT和TTP分别是22.13±14.24ml/100ml、99.27±58.56ml/100ml/min、15.65±11.20ml·100ml/min、14.95±4.03s、8.46±5.47s;甲状腺癌各参数BV、BF、PS、MTT和TTP分别是23.85±14.11ml/100ml、116.25±60.64ml/100ml/min、23.30±6.67ml/100ml/min、12.95±1.63s、7.16±3.16s;亚急性甲状腺炎各参数BV、BF、PS、MTT和TTP分别是44.48±15.98ml/100ml、202.90±44.41ml/100ml/min、34.18±9.15ml/100ml/min、10.64±0.98s、6.03±2.47s;三组数据间进行比较,BV、BF、PS、TTP总体差异均有统计学意义,MTT差异无统计学差异。结节性甲状腺肿术前甲状腺激素水平TSH、FT3、FT4分别是1.769±0.856m IU/L、3.166±0.681pg/m L、1.537±1.335ng/d L;甲状腺癌TSH、FT3、FT4分别是2.138±1.074m IU/L、3.110±0.708pg/ml、1.750±1.919ng/d L;亚急性甲状腺炎TSH、FT3、FT4分别是1.091±1.052m IU/L、3.523±0.398pg/m、1.481±0.289ng/d L;三组数据间进行比较,术前血清TSH差异有统计学意义,FT3、FT4差异无统计学意义;对所有病例按术前TSH水平重新分组统计,三组病例甲状腺癌发生率差异无统计学意义。不同甲状腺结节各灌注参数BV、BF、PS、TTP与术前血清甲状腺激素TSH水平作相关性分析,结果显示各组P值均>0.05,表明BV、BF、PS、TTP与TSH间均无明确相关性。结论 CT灌注参数PS、TTP、BV、BF以Objective To explore the clinical value of CT perfusion imaging and its biomedical indexes in diagnosis and differential diagnosis of single thyroid lesion. Also,to study the incidence relation between the CT perfusion parameters and thyroid hormones. Methods 93 cases with singal thyroid nodule were selected divided into three groups,nodular goiter group（NG,n=48,which include nodular goiter with adenoma group）,thyroid carcinoma group（TC,28）,subacute thyroiditis（ST,17）. All three groups received the conventional CT scan and layer dynamic perfusion scan. The data of blood volume（BV）,blood flow（BF）,permeability surface area product（PS）,mean transit time（MTT） and the time to peak（TTP） as well as the preoperative serum thyroid-stimulating hormone（TSH）,free triiodothyronine（FT3）,free thyroxin（FT4） were calculated. Utilized Pearson＇s Analytic Model was used to analyze and compare the data of CT perfusion parameters and its biomedical indexes. Results The mean parameters of BV、BF、PS、MTT and TTP in NG group were 22.13±14.24 ml/100 ml、99.27±58.56 ml/100 ml/min、15.65±11.20 ml·100 ml/min、14.95±4.03 s、8.46 ±5.47 s,respectively;The mean parameters of BV、BF、PS、MTT and TTP in TC group were 23.85 ±14.11 ml/100 ml、116.25 ±60.64 ml/100 ml/min、23.30 ±6.67 ml/100 ml/min、12.95 ±1.63 s、7.16 ±3.16 s,respectively;The mean parameters of BV、BF、PS、MTT and TTP in ST group were 44.48±15.98 ml/100 ml、202.90±44.41 ml/100 ml/min、34.18±9.15 ml/100 ml/min、10.64±0.98 s、6.03±2.47 s,respectively;There were significant differences in BV、BF、PS、TTP among the three groups,but not in MTT. The mean levels of preoperative serum TSH、FT3、FT4 in NG group were 1.769 ±0.856 m IU/L、3.166 ±0.681 pg/ml、1.537 ±1.335 ng/d L;The mean levels of TSH、FT3、FT4 in TC group were 2.138±1.074 m IU/L、3.110±0.708 pg/ml、1.750±1.919 ng/d L;The mean levels of TSH、FT3、FT4 in ST group were 1.091 ±1.052 m IU/L、3.523 ±0.398 pg/m、1.481 ±0.289 ng/

关 键 词：单发甲状腺结节 CT灌注 甲状腺激素类 促甲状腺激素 

分 类 号：R816.6[医药卫生—放射医学]