能谱CT定量参数联合血清TSHR-mRNA对甲状腺微小乳头状癌的诊断价值  

Diagnostic value of energy spectrum CT quantitative parameters combined with serum TSHR-mRNA for papillary thyroid microcarcinoma

作　　者：张卫国[1] 刘佳萍[2] 李向南[1] 张继洋 ZHANG Weiguo;LIU Jiaping;LI Xiangnan;ZHANG Jiyang(Department of Radiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Department of Radiology,Beijing Chest Hospital Affiliated to Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020 [2]首都医科大学附属北京胸科医院放射科,北京101149

出　　处：《实用放射学杂志》2024年第1期27-31,共5页Journal of Practical Radiology

摘　　要：目的探讨能谱CT定量参数联合血清促甲状腺激素受体-信使核糖核酸(TSHR-mRNA)对甲状腺微小乳头状癌(PTMC)的诊断价值。方法收集经手术及病理证实为甲状腺微小结节的患者105例,其中61例为PTMC(PTMC组);44例为微小结节性甲状腺肿(MNG)(MNG组)。比较2组能谱CT定量参数、血清TSHR-mRNA表达量。采用受试者工作特征(ROC)曲线分析能谱CT定量参数单独及联合血清TSHR-mRNA对PTMC的诊断价值。结果PTMC组和MNG组能谱CT定量参数碘浓度和能谱曲线斜率(k)在平扫期、动脉期、静脉期比较差异均有统计学意义(P<0.05)。PTMC组患者血清TSHR-mRNA的平均表达量高于MNG组(P<0.05)。能谱CT定量参数联合血清TSHR-mRNA诊断PTMC的曲线下面积(AUC)为0.913,且诊断PTMC的准确度、敏感度、阴性预测值显著高于能谱CT定量参数或血清TSHR-mRNA(P<0.05)。结论能谱CT定量参数和血清TSHR-mRNA均可单独对PTMC进行诊断,且两者联合诊断的价值更高。Objective To explore the diagnostic value of energy spectrum CT quantitative parameters combined with serum thyroid stimulating hormone receptor-messenger ribonucleic acid(TSHR-mRNA)for papillary thyroid microcarcinoma(PTMC).Methods A total of 105 patients with thyroid micronodules confirmed by surgery and pathology were collected,61 of whom were PTMC(PTMC group),and 44 patients with micronodular goiter(MNG)(MNG group).Energy spectrum CT quantitative parameters and serum TSHR-mRNA expression were compared between the two groups.The diagnostic value of energy spectrum CT quantitative parameters alone and combined with serum TSHR-mRNA for PTMC was analyzed by receiver operating characteristic(ROC)curve.Results The iodine concentration and slope of energy spectrum CT quantitative parameters between PTMC group and MNG group were significantly different in plain scan,arterial and venous phases(P<0.05).The mean serum TSHR-mRNA expression in the PTMC group was higher than that in MNG group(P<0.05).The area under the curve(AUC)for diagnosing PTMC using quantitative parameters of energy spectrum CT combined with serum TSHR-mRNA was 0.913,and the accuracy,sensitivity,and negative predictive value of diagnosing PTMC were significantly higher than those of quantitative parameters of energy spectrum CT or serum TSHRmRNA(P<0.05).Conclusion Both energy spectrum CT quantitative parameters and serum TSHR-mRNA can be used to diagnose PTMC alone,and the combination of both is more accurately.

关 键 词：能谱CT 促甲状腺激素受体-信使核糖核酸 甲状腺微小乳头状癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R736.1[医药卫生—放射医学]