基于直方图检查的CT强化扫描在鉴别诊断甲状腺良恶性结节中的价值  

Clinical value of CT enhanced scan based on histogram in differential diagnosis of benign and malignant thyroid nodules

作　　者：王桂东[1] 李雪菲 李劲浩 杨扬 孟凯龙[1] WANG Guidong;LI Xuefei;LI Jinhao;YANG Yang;MENG Kailong(CT and MR Room,The First Hospital of Handan,Handan,Hebei 056002,China)

机构地区：[1]邯郸市第一医院CT/MR室,河北邯郸056002

出　　处：《安徽医药》2023年第8期1601-1604,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨基于直方图检查的CT强化扫描用于甲状腺良恶性肿瘤鉴别诊断临床效能。方法回顾性分析邯郸市第一医院2017年1月至2020年6月收治具有明确病理组织学诊断结果甲状腺良恶性结节病人264例278个病灶临床资料,根据结节性质分为良性组(130个)和恶性组(148个);比较两组平扫和强化扫描CT直方图相关指标,描绘ROC曲线评价平扫及强化扫描CT直方图相关指标用于甲状腺良恶性结节鉴别诊断临床效能。结果恶性组CT平扫直方图均值,第10、50及90百分位数均显著高于良性组(P<0.05);恶性组CT强化扫描直方图均值,第1、10、50及90百分位数均显著高于良性组(P<0.05);恶性组CT强化扫描直方图方差显著低于良性组(P<0.05);ROC曲线分析结果显示,CT平扫及强化扫描直方图指标中用于甲状腺良恶性结节鉴别诊断中,CT强化扫描直方图第10百分位数的AUC最高(0.70),灵敏度和特异度分别为75.26%,63.75%(P<0.05)。结论基于直方图检查的CT强化扫描用于甲状腺良恶性结节鉴别诊断具有良好价值,其中CT强化扫描直方图第10百分位数可作为重要预测指标加以关注。Objective To investigate the clinical value of CT enhanced scan based on histogram in differential diagnosis of benign and malignant thyroid nodules.Methods Clinical data of 264 patients for 278 lesions with benign and malignant thyroid nodules with definite histopathological diagnosis in the the First Hospital of Handan from January 2017 to June 2020 were retrospectively chosen.All patients were assigned into 2 groups including benign group(130 lesions)and malignant group(148 lesions)according to nodules nature.The levels of plain scan and enhanced CT histograms were compared between 2 groups.ROC curve was used to evaluate the clinical value of histogram related indexes of plain scan and enhanced CT in differential diagnosis of benign and malignant thyroid nodules.Results The mean value of CT plain histogram,10th,50th and 90th percentile in malignant group were significantly higher than those in benign group(P<0.05).The contrast-enhanced CT histogram mean,1st,10th,50th and 90th percentile levels in malignant group were significantly higher than tnose in benign group(P<0.05).The variance of contrast-enhanced CT histogram in malignant group was significantly lower than that in benign group(P<0.05).ROC curve analysis showed that CT plain scan and enhanced scan histogram index were used in the differential diagnosis of benign and malignant thyroid nodule,AUC(0.70)was the highest in the 10th percentile of CT enhanced histograms,and the sensitivity and specificity were 75.26%and 63.75%respectively(P<0.05).Conclusion CT enhanced scan based on histogram examination has good value for the differential diagnosis of benign and malignant thyroid nodules,in which the 10th percentile of enhanced CT histogram can be used as the important predictor.

关 键 词：甲状腺结节 CT 直方图 鉴别诊断 

分 类 号：R736.1[医药卫生—肿瘤]