能谱CT参数在甲状腺实性结节性质判断中的作用  

Role of spectral CT parameters in the determination of the properties of solid thyroid nodul

作　　者：孟锦 胡子龙 肖艳 Meng Jin;Hu Zi-long;Xiao Yan(The Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,Henan,China)

机构地区：[1]乡医学院第四临床学院,河南新乡453000

出　　处：《四川生理科学杂志》2022年第10期1736-1740,1815,共6页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨能谱CT参数在鉴别诊断甲状腺实性结节性质中的价值。方法:选取2018年8月至2022年5月因甲状腺实性结节来院就诊的患者100例,根据患者入院手术病理检查结果将其分为良性组和恶性组。所有患者均接受能谱CT扫描,对比两组患者影像学表现,比较两组病灶、正常甲状腺组织、颈总动脉碘含量(Iodine concentration,IC)、动脉标准化碘含量(Normalized iodine concentration in arterial,NICA)、正常甲状腺标准碘含量(Normal thyroid standard iodine content,NIC T)及能谱曲线斜率(Spectrum curve slope,γHU)、钙浓度。采用Spearman相关分析CT相关参数与甲状腺实性结节性质关系,并绘制受试者工作曲线(Receiver operating characteristic curve,ROC)分析相关能谱参数对甲状腺实性结节病变性质的诊断效能。结果:100例患者病理检查共计检出结节126个,能谱CT诊断甲状腺实性结节良性检出率为90.41%,恶性检出率90.57%;恶性组IC_(病灶)、IC_(甲状腺)、NICA、NICT、γHU、钙浓度均低于良性组(P<0.05);Spearman相关分析显示IC_(病灶)、NICA、NICT、γHU、钙浓度均与甲状腺实性结节良恶性呈正相关(r=0.593,r=0.452,r=0.365,r=0.371,r=0.789,P<0.05);ROC曲线分析显示,IC_(病灶)、NICA、NICT、γHU、钙浓度诊断患者发生甲状腺实性结节性质的最佳截断点分别为3.14 mg·mL^(-1)、0.49、0.67、3.79、6.44 mg·cm^(-3),AUC分别为0.714(95%CI:0.639~0.801)、0.678(95%CI:0.592~0.773)、0.683(95%CI:0.616~0.724)、0.699(95%CI:0.561~0.767)、0.701(95%CI:0.618~0.792)。结论:不同性质的甲状腺实性结节的能谱CT参数存在差异,临床应用能谱CT可有效鉴别诊断甲状腺实性结节良恶性,效果显著,应用价值高。Objective:To explore the value of spectral CT parameters in the diagnosis and differentiation of the nature of solid thyroid nodules.Methods:A total of 100 patients with solid thyroid nodules who came to the hospital from August 2018 to May 2022 were selected,and they were divided into benign group and malignant group according to the results of surgical and pathological examinations.All patients received energy spectral CT scanning,and the imaging manifestations of the two groups were compared.The lesions,normal thyroid tissue,common carotid artery iodine contentration(IC),arterial normalized iodine content(NIC A),normal thyroid iodine content(NIC T),energy spectrum curve slope(γHU),and calcium concentration were compared between the two groups.Spearman correlation was used to analyze the relationship between CT-related parameters and the properties of solid thyroid nodules,and receiver operating curves(ROC)were drawn to analyze the diagnostic performance of related energy spectrum parameters for the properties of solid thyroid nodules.Results:A total of 126 nodules were detected by pathological examination in 100 patients.Energy spectral CT diagnosed solid thyroid nodules with a detection rate of 90.41%for benign and 90.57%for malignant.The IC lesions,IC thyroid,NICA,NICT,γHU,and calcium concentration in the malignant group were lower than those in the benign group(P<0.05).Spearman correlation analysis showed that IC lesions,NICA,NICT,γHU,calcium concentration were positively correlated with benign and malignant thyroid nodules(r=0.593,r=0.452,r=0.365,r=0.371,r=0.789,P<0.05).ROC curve analysis showed that the optimal cut-off points for IC lesions,NICA,NICT,γHU,and calcium concentration to diagnose the nature of solid thyroid nodules were 3.14 mg·mL^(-1),0.49,0.67,3.79,and 6.44 mg·cm^(-3),respectively.ROC curve analysis showed that the AUCs of IC lesions,NICA,NICT,γHU,and calcium concentration diagnosed patients with solid thyroid nodules were 0.714(95%CI:0.639-0.801),0.678(95%CI:0.592~0.773),0.683(95%CI:

关 键 词：能谱CT 能谱CT参数 甲状腺实性结节 诊断价值 

分 类 号：R581[医药卫生—内分泌]