多个CT征象单独及联合应用在甲状腺滤泡癌与滤泡性腺瘤鉴别诊断中的价值  

The value of multiple CT signs alone and in combination in the differential diagnosis of thyroid follicular carcinoma and follicular adenoma

作　　者：林婵君 陈夏浦 郑旭峰[2] 孙建鸿 林黛英[2] 马树华[1] LIN Chanjun;CHEN Xiapu;ZHENG Xufeng;SUN Jianhong;LIN Daiying;MA Shuhua(Department of Radiology,The First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Department of Radiology,Shantou Central Hospital,Shantou 515041,China;Department of Pathology,Shantou Central Hospital,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院放射科,广东汕头515041 [2]汕头市中心医院放射科,广东汕头515041 [3]汕头市中心医院病理科,广东汕头515041

出　　处：《汕头大学医学院学报》2024年第4期207-211,共5页Journal of Shantou University Medical College

基　　金：汕头市医疗卫生科技计划(230509116495613)。

摘　　要：目的:探讨多个CT征象单独及联合应用在甲状腺滤泡癌(follicular thyroid carcinoma,FTC)和甲状腺滤泡性腺瘤(follicular thyroid adenoma,FTA)鉴别诊断中的价值。方法:回顾性纳入2019年2月—2024年5月于汕头市中心医院接受颈部CT检查且经术后组织病理诊断的31例FTC和69例FTA患者。比较两组CT征象(包括局限性突起、蛋壳样钙化、多结节征、边界模糊等4种)的差异。以术后病理结果为金标准,比较4种CT征象单独及联合使用对FTC的诊断效能。结果:与FTA相比,局限性突起、蛋壳样钙化、多结节征、边界模糊等4种CT征象均更多见于FTC (均P<0.05)。单个CT征象中,局限性突起的诊断价值最大,其灵敏度、特异度、准确度分别为67.7%、97.1%、88%;2种CT征象联合诊断中,局限性突起+其他任意1种征象的特异度均为100%,其中局限性突起+边界模糊的灵敏度、特异度、准确度均最高,分别为45.1%、100%、83%;3种CT征象联合诊断中,局限性突起+蛋壳样钙化+边界模糊的灵敏度、特异度、准确度最高,分别为32.2%、100%、79%;4种CT征象联合诊断的灵敏度、特异度、准确度分别为3.2%、100%、70%。结论:局限性突起对FTC和FTA具有较高的鉴别诊断价值,而多个CT征象联合可提高诊断特异度。Objective:To investigate the value of multiple CT signs alone and in combination in the differential diagnosis of follicular thyroid carcinoma(FTC) and follicular thyroid adenoma(FTA).Methods:31 patients with FTC and 69 patients with FTA who underwent neck CT at Shantou Central Hospital from February 2019 to May2024 and were diagnosed by postoperative histopathology were retrospectively included.The differences in CT signs(including four types of localized protrusion,eggshell-like calcification,multi-nodule sign,and border blurring) between the two groups were compared.Postoperative pathologic findings were used as the gold standard to compare the diagnostic efficacy of the four CT signs alone and in combination for FTC.Results:Compared with FTA,all 4 CT signs,including localized protrusion,eggshell-like calcification,multi-nodule sign,and border blurring,were more common in FTC(all P<0.05).Among the single CT signs,localized protrusion had the greatest diagnostic value,with a sensitivity,specificity,and accuracy of 67.7%,97.1%,and 88%,respectively;in the combined diagnosis of the 2 CT signs,the specificity of localized protrusion + any of the other signs was 100%,and localized protrusion + border blurring had the highest sensitivity,specificity,and accuracy,with 45.1%,100%,and 83%,respectively;and the sensitivity,specificity,and accuracy of the combined diagnosis of the 3 CT signs were highest for localized protrusion + eggshell-like calcification + border blurring,with 32.2%,100%,and79%,respectively;and for the combined diagnosis of the 4 CT signs,the sensitivity,specificity,and accuracy were3.2%,100%,and 70%,respectively.Conclusion:Localized protrusion has a high differential diagnostic value for FTC and FTA,while multiple CT signs combined can improve diagnosis specificity.

关 键 词：甲状腺滤泡癌 甲状腺滤泡性腺瘤 鉴别诊断 体层摄影术 X线计算机 

分 类 号：R581[医药卫生—内分泌]