CT联合超声检测在甲状腺乳头状腺癌诊断中的应用研究  

Application of CT combined ultrasonography in diagnosis of papillary thyroid carcinoma

作　　者：杨千朋 康瑞 Yang Qianpeng;Kang Rui(Medical Imaging Department of Shaanxi Province Nuclear Industry 215 Hospital(Xianyang 712000))

机构地区：[1]陕西省核工业二一五医院医学影像科,咸阳712000 [2]陕西省咸阳市第一人民医院超声科,咸阳712000

出　　处：《陕西医学杂志》2018年第10期1287-1289,1299,共4页Shaanxi Medical Journal

基　　金：陕西省自然科学基金资助项目(2006C249)

摘　　要：目的:研究CT联合超声检测在甲状腺乳头状腺癌(PTC)诊断中的应用。方法:收集在我院进行治疗的PTC患者的临床资料147例作为PTC组,另选取同时期确诊为甲状腺腺瘤的患者318例作为对照组,收集两组患者的术前超声和CT诊断资料,以及术后病理诊断确诊资料。超声诊断过程中,依据患者的超声声像图以及血流信号进行观察,并从质地、钙化程度、淋巴结纵横比、边界、回声、结节数量、阻力指数等方面进行分析;CT诊断过程中,从强化环、形态、钙化灶、囊内乳头状结节、边界、浸润等方面进行分析;比较超声单独诊断、CT单独诊断以及二者联合诊断与术后病理诊断相比的敏感度、特异度及符合率。结果:PTC组和对照组患者在血流信号、钙化灶、回声、边界、纵横比和阻力指数方面差异显著(P<0.05);两组患者在质地和结节数量方面无统计学意义(P>0.05)。超声检查对PTC诊断的敏感度为77.91%,特异度93.37%,符合率87.95%。PTC组和对照组在强化环、形态、钙化灶、囊内乳头状结节、边界和密度方面均有显著性差异(P<0.05)。CT检查对PTC诊断的73.45%,特异度90.76%,符合率84.73%。超声与CT联合诊断对PTC诊断的敏感度为89.26%,特异度94.97%,符合率93.55%。超声联合CT诊断符合率显著高于超声诊断和CT诊断。结论:CT联合超声诊断能够显著提高PTC的诊断符合率,值得在临床上推广应用,CT和超声在不同颈部淋巴结分区之间的应用还需要进一步研究。Objective:The application of CT combined ultrasonography in diagnosis of Papillary Thyroid Carcinoma(PTC)were studied.Methods:147 cases of PTC patients treated in our hospital were selected as PTC group,and 318 patients with thyroid adenoma diagnosed at the same time as control group.The preoperative ultrasound and CT diagnosis data of two groups of patients,and postoperative pathological diagnosis confirmed data were collected.In the ultrasonic diagnosis process,observations were made based on the patient's ultrasound sonogram and blood flow signals,and analyzed from the aspects of texture,calcification,lymph node aspect ratio,boundary,echo,number of nodules,resistance index,etc.In the course of CT diagnosis,the analysis was performed from the aspects of strengthening rings,morphology,calcification,intracapsular papillary nodules,borders,and infiltration.The sensitivity,specificity,and coincidence rate of ultrasound alone,CT alone,and the combination of the two were comparied with postoperative pathology.Results:There were significant differences in blood flow signal,calcification,echo,border,aspect ratio,and resistance index between the PTC group and the control group(P<0.05).There was no significant difference in texture and number of nodules between the two groups(P>0.05).The sensitivity of ultrasound examination for PTC diagnosis was 77.91%,specificity was 93.37%,and the coincidence rate was 87.95%.The CT scan showed a 73.45%diagnosis of PTC with a specificity of 90.76%,a rate of 84.73%.The combined diagnosis of ultrasound and CT has a sensitivity of 89.26%,a specificity of 94.97%,and a coincidence rate of 93.55%.The coincidence rate of ultrasound combined with CT was significantly higher than that of ultrasound and CT.Conclusion:CT combined with ultrasonography can significantly improve the diagnostic coincidence rate of PTC,which is worthy of clinical application.The application of CT and ultrasound in lymph node dissection in different cervical regions needs further study.

关 键 词：甲状腺肿瘤/诊断 体层摄影术 X线计算机 超声检查 

分 类 号：R736.1[医药卫生—肿瘤]