高频超声联合螺旋CT诊断甲状腺癌的价值分析  

The Value Analysis of High Frequency Ultrasound Combined with Spiral CT in Diagnosis of Thyroid Cancer

作　　者：吴劲峰 Wu Jinfeng(Department of Health Management,Dongguan City Peoples Hospital,Dongguan,Guangdong 523000)

机构地区：[1]广东省东莞市人民医院健康管理科,广东东莞523000

出　　处：《现代医用影像学》2020年第7期1233-1236,共4页Modern Medical Imageology

摘　　要：目的:探讨CT联合高频超声(HFUS)对各种甲状腺癌的诊断价值,分析其影像表现,并进行鉴别诊断,旨在提高对甲状腺癌的超声诊断水平。方法:回顾性收集本院2018年1月~2019年12月间经手术或穿刺病理确诊的86例甲状腺癌患者,分析其HFUS和CT表现特点,并与病理结果进行对照,统计CT、超声及联合两者诊断甲状腺癌的准确性。结果:在86例甲状腺癌中,乳头状癌76例,滤泡状癌5例,髓样癌3例,未分化癌2例。甲状腺癌的高频超声表现为:低回声结节,内部回声不均匀,边界不清,可以形态不规则,可有点状高亮回声钙化灶,无完整包膜,可侵犯邻近结构及颈部肿大淋巴结,彩色多普勒超声显示肿瘤边缘血流丰富。甲状腺癌的CT表现为:低密度结节影,境界不清,可伴斑点状高密度钙化灶,增强后肿瘤轻度强化。联合超声和CT检查诊断乳头状癌的正确率是98.00%,诊断滤泡状癌及未分化癌的正确率均是90.00%,诊断髓样癌的正确率是83.33%。联合应用诊断效果明显高于单一超声或CT检查(P<0.05),而高频超声与CT检查两者间比较在诊断效果方面无统计学差异(P>0.05)。结论:联合超声与CT检查能明显提高甲状腺癌的诊断准确性,而单一的超声或CT检查在诊断甲状腺癌方面无明显差别。Objective:To explore the diagnostic value of CT combined with high frequency ultrasound(HFUS)for various thyroid cancer,analyze its imaging manifestations and make differential diagnosis,so as to improve the ultrasonic diagnostic level for thyroid cancer.Methods:86 patients with thyroid cancer diagnosed by surgery or puncture pathology from January 2018 to December 2019 in our hospital were retrospectively collected,their HFUS and CT manifestations were analyzed and compared with pathological results,and the accuracy of CT,ultrasound and combined diagnosis of thyroid cancer were statistically analyzed.Results:Among 86 cases of thyroid carcinoma,76 cases were papillary carcinoma,5 cases were follicular carcinoma,3 cases were medullary carcinoma and 2 cases were undifferentiated carcinoma.The high-frequency ultrasound manifestations of thyroid cancer are:hypoechoic nodule,uneven internal echo,unclear boundary,irregular shape,punctiform highlight echo calcification,no complete capsule,invasion of adjacent structures and swollen lymph nodes in neck,color Doppler ultrasound shows rich blood flow at tumor edge.CT manifestations of thyroid cancer are:low density nodule shadow,unclear boundary,punctate high density calcification,and slight enhancement after enhancement.The accuracy rate of combined ultrasound and CT examination in the diagnosis of papillary carcinoma is 98.00%,that of follicular carcinoma and undifferentiated carcinoma is 90.00%,and that of medullary carcinoma is 83.33%.The diagnostic effect of combined application was significantly higher than that of single ultrasound or CT examination(P<0.05),while there was no statistical difference in diagnostic effect between high frequency ultrasound and CT examination(P>0.05).Conclusion:Combined ultrasound and CT examination can obviously improve the diagnostic accuracy of thyroid cancer,while single ultrasound or CT examination has no obvious difference in the diagnosis of thyroid cancer.

关 键 词：甲状腺癌 高频超声检查 体层摄影术 X线计算机 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学] R730.44[医药卫生—临床医学]