能谱曲线对甲状腺癌与颈部转移淋巴结相关性的价值  

Energy Spectrum Curve in Probing Correlation Between Thyroid Carcinoma and Cervical Lymph Node Metastasis

作　　者：张夏[1] 赵雯[1] 韩丹[1] 沈莎莎 李俊丽 ZHANG Xia;ZHAO Wen;HAN Dan;SHEN Shasha;LI Junli(Department of Medical Imaging,the First Affiliated Hospital,Kunming Medical University,Kunming 65003)

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032

出　　处：《中国医学影像学杂志》2018年第7期505-508,511,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨能谱曲线斜率对甲状腺结节定性诊断及发现甲状腺癌转移淋巴结的价值,研究甲状腺癌与转移淋巴结的相关性。资料与方法回顾性分析2013年1月-2015年12月在昆明医科大学第一附属医院经手术病理证实的200例甲状腺结节患者,均经颈部双能量CT行双期增强扫描,根据病理结果将结节分为恶性结节和良性结节,其中恶性120例,良性80例。104例一侧叶结节完全无病变,视为正常甲状腺组织。比较正常甲状腺组织与良、恶性结节的能谱曲线斜率。120例恶性结节中,甲状腺癌并颈部淋巴结转移且可与手术精准定位的淋巴结55枚,无淋巴结转移且可见淋巴结门45枚,比较转移淋巴结与正常淋巴结的能谱曲线斜率。55例甲状腺癌并淋巴结转移的患者中,分析动、静脉期甲状腺癌结节与转移淋巴结的相关性。结果 (1)静脉期甲状腺正常组织、恶性结节、良性结节的能谱曲线斜率分别为4.71±0.95、3.56±1.05、4.13±1.06,差异有统计学意义(P<0.05);动脉期分别为7.38±1.85、4.38±1.33、4.43±1.47,差异无统计学意义(P>0.05)。(2)动脉期转移淋巴结与正常淋巴结的能谱曲线斜率分别为5.52±2.48、2.12±0.78,差异有统计学意义(t=8.348,P<0.01);静脉期分别为3.70±0.96、2.33±0.75,差异有统计学意义(t=7.351,P<0.01)。(3)甲状腺癌与转移淋巴结能谱曲线斜率在动脉期(r=0.44,P<0.05)和静脉期(r=0.90,P<0.05)均有相关性。结论双能量CT能谱曲线斜率对鉴别甲状腺良、恶性结节以及发现甲状腺癌转移淋巴结有一定的价值。Purpose To explore the value of energy spectrum slope curve in qualitative diagnosis of thyroid nodules and in detecting metastatic lymph nodes of thyroid cancer,and to study the correlation between thyroid cancer and metastatic lymph nodes.Materials and Methods Two hundred patients with thyroid nodules confirmed by surgical pathology treated in the First Affiliated Hospital of Kunming Medical University from January 2013 to December 2015 were retrospectively analyzed.All patients received cervical dual-energy CT coupled with biphasic contrast enhancement,and the nodules were categorized into malignant and benign ones as per pathological results（120 malignant cases and 80 benign cases）.Cases in which there was no lesion in one lateral lobe of the nodules were deemed as normal thyroid tissue（104 cases）.The energy spectrum slope curve of normal thyroid tissues was compared with that of benign and malignant nodules using one-way analysis of variance.Among the 120 malignant nodules,there were 55 lymph nodes consisting of the ones diagnosed with thyroid cancer combined with cervical lymph node metastasis and the others that could achieve precise positioning through surgery,and there were 45 lymph nodes spotted no lymph node metastasis with lymph node hilum visible.The energy spectrum slope curve of metastatic lymph nodes was compared with that of normal lymph nodes.In 55 patients contracted with thyroid cancer and lymph node metastasis,the correlation between thyroid nodules and metastatic lymph nodes in arterial and venous phases was analyzed.Results（1）The energy spectrum slope curve of thyroid normal tissues,malignant nodules and benign nodules were 4.71±0.95,3.56±1.05,and 4.13±1.06 respectively in venous phase,the difference of which was statistically significant（P〈0.05）; and in arterial phase were 7.38±1.85,4.38±1.33,and 4.43±1.47 respectively,the difference of which was not statistically significant.（2）The energy spectrum slope curve of metastatic and normal lymph nodes in arterial pha

关 键 词：甲状腺肿瘤 淋巴转移 体层摄影术 X线计算机 病理学 外科 

分 类 号：R445[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学]