双源CT单能量CT值及能谱曲线对甲状腺实性结节性质鉴别诊断的价值分析  

Analysis of the value of dual source CT single energy CT value and energy spectrum curve in differential diagnosis of solid thyroid nodules

作　　者：吴树剑 俞咏梅[1] 徐静雅 范莉芳 Wu Shujian;Yu Yongmei;Xu Jingya;Fan Lifang(Yijishan hospital affiliated to Wannan Medical College,Wuhu,Anhui,241000,China;School of medical image,Wannan Medical College,Wuhu,Anhui,241000,China)

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241001 [2]皖南医学院医学影像学院,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2022年第2期165-168,共4页Journal of Qiqihar Medical University

基　　金：皖南医学院中青年科研基金(WK202003);皖南医学院教学质量与教学改革工程(2020jyxm43)。

摘　　要：目的分析双源CT(DSCT)单能量下CT值及平均能谱曲线对甲状腺实性结节良恶性鉴别诊断的价值。方法选择2019年12月—2020年12月本院收治的53例甲状腺良、恶性结节患者作为研究对象,按诊断分为恶性结节组25例,良性结节组28例(其中15例为结节性甲状腺肿,13例为甲状腺腺瘤),术前行双源CT能谱成像。另选取20例甲状腺无任何疾病的患者作为对照组。记录不同类型结节在不同期相下的单能量CT值,绘制ROC曲线,计算约登指数;绘制不同类型结节及正常甲状腺组织的平均能谱曲线,比较曲线斜率。结果平扫期(C)50 keV、动脉期(A)60 keV、静脉期(V)70 keV下对结节的良恶性诊断的效能最高,诊断临界CT值分别为68.65 HU、171.8 HU、152.35 HU,所对应的灵敏度、特异度及约登指数分别为96.4%、44.0%、0.404,89.3%、80.0%、0.693,78.6%、88.0%、0.666;三期各组研究对象的能谱曲线斜率差异均有统计学意义(P<0.05)。结论DSCT单能量下CT值及能谱衰减曲线有助于鉴别甲状腺结节的性质。Objective To analyze the value of dual source CT(DSCT)single energy CT value and energy spectrum curve in the benign and malignant differential diagnosis of solid thyroid nodules.Methods 53 patients with benign or malignant thyroid nodules those were treated in our hospital during December 2019 and December 2020 were selected as the research objects,including 25 cases of malignant nodules and 28 cases of benign nodules(among them,15 were nodular goiter and 13 were thyroid adenoma),Dual source CT energy spectrum imaging was performed before operation.Another 20 patients without any thyroid disease were selected as the control group.The single energy CT values of nodules in different phases were recorded,the ROC curve was drawn,and the Youden index was calculated.The average energy spectrum curves of different types of nodules and normal thyroid tissues were drawn and the slope of the curves was compared.Results The diagnostic efficiency of 50 keV in plain scan(C),60 keV in arterial phase(A)and 70 keV in venous phase(V)was the highest.The critical CT values were 68.65 Hu,171.8 Hu and 152.35 Hu,respectively.The corresponding sensitivity,specificity and Youden index of them were(96.4%,44.0%,and 0.404),(89.3%,80.0%,and 0.693),(78.6%,88.0%,and 0.666),respectively.There were significant differences in the slope of energy spectrum curve between groups at the three different phase(P<0.05).Conclusions DSCT single energy CT value and energy spectrum attenuation curve are helpful to identify the nature of thyroid nodules.

关 键 词：双源CT 单能量CT值 能谱曲线 甲状腺结节 

分 类 号：R581[医药卫生—内分泌]