双能量CT电子云密度和有效原子序数在甲状腺良恶性结节鉴别诊断中的价值  

The value of dual-energy CT electron cloud density and effective atomic number in differential diagnosis of benign and malignant thyroid nodules

作　　者：钟丽茹 罗娜 唐文杰[1] ZHONG Liru;LUO Na;TANG Wenjie(Department of Radiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院放射科,广东广州510630

出　　处：《新医学》2024年第9期716-721,共6页Journal of New Medicine

基　　金：广东省自然科学基金面上项目(2022A1515010369)。

摘　　要：目的探讨双能量CT电子云密度(Rho)及有效原子序数(Z)在甲状腺良恶性结节鉴别诊断中的价值。方法回顾性分析2023年3月至12月在中山大学附属第三医院岭南医院经病理证实的68例甲状腺结节患者影像资料。68例中,良性结节31例、恶性结节37例,均于术前1周内接受颈部CT平扫联合增强双能量扫描。利用后处理工作站重建动脉期、静脉期Rho及Z图并测量其数值,比较甲状腺良性与恶性结节的Rho值及Z值,分析差异有统计学意义的双能量参数,利用受试者操作特征(ROC)曲线分析其在甲状腺结节良性与恶性中的鉴别诊断效能。结果动静脉期Z值和静脉期Rho值在甲状腺良性与恶性结节间比较差异均无统计学意义(P均>0.05),动脉期Rho值在甲状腺良性与恶性结节间比较差异有统计学意义(P<0.05),甲状腺恶性结节的动脉期Rho值高于良性结节,其ROC曲线下面积为0.711(95%CI 0.586~0.836),灵敏度为73.0%,特异度为64.5%。当动脉期Rho值为38.60 Hu时,其鉴别诊断效能最高。结论双能量CT动脉期Rho值对甲状腺良恶性结节的鉴别诊断有一定价值。Objective To investigate the differential diagnostic value of dual-energy CT electron cloud density(Rho)and effective atomic number(Z)between benign and malignant thyroid nodules.Methods Imaging data of 68 patients with pathologically confirmed thyroid nodules at Lingnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University from March to December 2023 were retrospectively analyzed.Among the 68 cases,31 patients were diagnosed with benign thyroid nodules and 37 with malignant thyroid nodules.All patients underwent plain CT scan combined with enhanced dual-energy CT scan of the neck in the first week before surgery.The arterial-phase and venous-phase electron cloud density maps and effective atomic number maps were reconstructed in the post-processing workstation.Rho and Z values of benign and malignant thyroid nodules were compared by Mann-Whitney U test.Statistically significant dual-energy parameters were analyzed and their differential diagnostic efficiency in diagnosing benign and malignant thyroid nodules was calculated using the receiver operating characteristic(ROC)curve.Results Arterial-and venousphase Z values and venous-phase Rho were not statistically significant between benign and malignant thyroid nodules(all P>0.05),whereas arterial-phase Rho value was statistically significant between benign and malignant thyroid nodules(P<0.05).The arterialphase Rho of malignant thyroid nodules was higher than that of the benign thyroid nodules,with an area under the ROC curve(AUC)of 0.711(95%CI 0.586-0.836),a sensitivity of 73.0%,and a specificity of 64.5%.The differential diagnostic efficiency was the highest when the arterial-phase Rho was 38.6 Hu.Conclusion Dual-energy CT arterial-phase Rho mapping has certain value in the differential diagnosis of benign and malignant thyroid nodules.

关 键 词：双能量CT 电子云密度图 有效原子序数 甲状腺结节 

分 类 号：R581[医药卫生—内分泌]