CT检查对甲状腺腺瘤和甲状腺癌的鉴别诊断价值  

Value of CT in Differential Diagnosis of Thyroid Adenoma and Thyroid Carcinoma

作　　者：钱娟[1] 周雅芬 Qian Juan;Zhou Yafen(Department of Radiology,Wuzhong People's Hospital,Suzhou,Jiangsu 215128)

机构地区：[1]苏州市吴中人民医院放射科,江苏苏州215128

出　　处：《现代医用影像学》2024年第10期1798-1801,共4页Modern Medical Imageology

摘　　要：目的:探讨CT平扫及增强检查在甲状腺腺瘤与甲状腺癌鉴别诊断中的价值。方法:收集本院2019年1月至2023年3月经手术病理学确诊为甲状腺腺瘤14例与甲状腺癌50例患者,回顾性分析其CT平扫及增强影像特征,并统计比较两种甲状腺肿瘤之间的CT征象差异性,计算CT检查鉴别诊断两者的效能。结果:甲状腺腺瘤中,单侧发病12例,双侧发病2例;甲状腺癌中,单侧发病26例,双侧发病24例,两者比较有统计学差异(P<0.05)。CT平扫征象中,肿瘤的边界、钙化灶、包膜征、囊变程度在两种甲状腺肿瘤间比较均有统计学差异(P<0.05);甲状腺癌更倾向于肿瘤边界模糊不清、伴细小钙化、包膜不完整中断、少囊变、多伴颈淋巴结转移。CT增强扫描后,甲状腺癌强化程度更高,明显强化者占比甲状腺腺瘤与甲状腺癌分别为30%和70%,两者比较具有统计学差异(P<0.05)。CT检查鉴别诊断两者的灵敏度为72.0%、特异度71.4%、准确率71.9%、阳性预测值90%、阴性预测值41.7%。结论:CT平扫和增强扫描对甲状腺癌和甲状腺腺瘤的鉴别诊断具有重要价值,为临床诊断、干预治疗及预后评估提供影像学参考依据。Objective:To explore the value of plain and enhanced CT in the differential diagnosis of thyroid adenoma and thyroid carcinoma.Methods:From January 2019 to March 2023,14 patients with thyroid adenoma and 50 patients with thyroid cancer diagnosed by surgery and pathology were collected,and their CT plain scan and enhanced image characteristics were analyzed retrospectively,and the differences of CT signs between the two thyroid tumors were statistically compared.The effectiveness of CT examination in differential diagnosis of both was calculated.Results:Among thyroid adenomas,12 cases were unilateral and 2 cases were bilateral.Among thyroid cancer,26 cases were unilateral and 24 cases were bilateral,and there was a statistical dfference between them(P<0.05).On CT plain scan,there were statistical diferences in tumor boundary,calcification,capsule sign and cystic change between the two thyroid tumors(P<0.05).Thyroid cancer is more prone to vague tumor boundary,with tiny calcification,incomplete capsule interruption,few cystic changes and cervical lymph node metastasis.After enhanced CT scanning,thyroid cancer was enhanced to a higher degree accounting for 30%of thyroid adenoma and 70%of thyroid cancer,with statistical difference(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT in differential diagnosis were 72.0%,71.4%,71.9%,90%and 41.7%respectively.Conclusion:CT plain scan and enhanced scan are of great value in the differential diagnosis of thyroid cancer and thyroid adenoma,and provide imaging reference for clinical diagnosis,intervention treatment and prognosis evaluation.

关 键 词：CT平扫和增强 甲状腺腺瘤 甲状腺癌 鉴别诊断 

分 类 号：R73[医药卫生—肿瘤]