双源CT双能量碘图对甲状腺结节的鉴别价值  

Differential Value of the Dual-source CT Dual-energy Iodine Map for the Thyroid Nodules

作　　者：王庆云[1] 吴凌梅 高凤霄[1] WANG Qing-yun;WU Ling-mei;GAO Feng-xiao(CTMRI,Xingtai People's Hospital,Hebei 054031,China;Nuclear Medicine Department,Xingtai People's Hospital,Hebei 054031,China)

机构地区：[1]邢台市人民医院CTMRI科,河北054031 [2]邢台市人民医院核医学科,河北054031

出　　处：《影像技术》2022年第2期25-28,39,共5页Image Technology

基　　金：邢台市重点研发计划项目(2020ZC278)。

摘　　要：目的:探究双源CT双能量碘图在甲状腺结节的良恶性鉴别诊断中的价值。方法:在邢台市人民医院2013年6月-2019年6月收诊的甲状腺结节患者中选出102例(142个结节)为研究对象,均在CT科接受双源CT扫描,进行双能量平扫和增强扫描,以手术病理或穿刺活检结果为金标准,收集整理双源CT双能量碘图对良恶性结节的诊断符合率等。结果:良恶性结节在动脉期的NIC值和标准化CT值比较,差异均无统计学意义,P>0.05;静脉期的NIC值和标准化CT值,良性结节均高于恶性结节,P<0.05;良性结节的形态规则检出率高于恶性结节,P<0.05;良性结节的包膜不完整/无包膜检出率、钙化检出率均低于恶性结节,P<0.05;经ROC曲线分析,静脉期鉴别诊断良恶性的最佳临界值NIC值为0.75,标准化CT值为0.78HU,且小于临界值时的AUC分别为0.90、0.92,静脉期NIC值与标准化CT值在良恶性结节鉴别诊断中的敏感度和特异度与形态学鉴别诊断灵敏度、特异度一致性高。结论:双源CT双能量碘图在良恶性甲状腺结节的鉴别诊断中应用价值高,静脉期的NIC值、标准化CT值和碘图形态学能早期判断结节的良恶性,指导临床治疗。Objective:To explore the value of dual-source CT dual-energy iodine map in the differential diagnosis of benign and malignant diseases of thyroid nodules.Methods:in Xingtai people’s hospital from June 2013-June 2019 of thyroid nodule patients selected 102 cases(142 nodules),all in CT scan,double energy flat scan and enhanced scan,with surgical pathology or puncture biopsy results as the gold standard,collect and organize double source CT double energy iodine chart for the diagnosis of benign and malignant nodules,etc.Results:NIC and standardized CT values between benign and malignant nodules in arterial stage,P>0.05;NIC values and standardized CT values in the venous period,Both the benign nodules were higher than the malignant nodules,P<0.05;The detection rate of benign nodules was higher than malignant nodules,P <0.05;Moreover,the capsule is incomplete/no capsule detection rate and calcification detection rate of benign nodules are lower than that of malignant nodules,P<0.05;After the ROC curve analysis,The optimal cut-off value of NIC was 0.75,The normalized CT value was 0.78HU,And the AUC when less than the critical value is 0.90 and 0.92,respectively,The sensitivity and specificity between venous NIC values and standardized CT values in the differential diagnosis of morphology and the differential diagnosis of benign and malignant nodules are high.Conclusion:Dual-source CT double-energy iodine map has a high application value in the differential diagnosis of benign and malignant thyroid nodules.The NIC value,standardized CT value and iodine map morphology can make an early judgment of the benign and malignant nodules and guide the clinical treatment.

关 键 词：双源CT 双能量碘图 甲状腺结节 良恶性 鉴别诊断 一致性 

分 类 号：R736.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]