增强CT征象和CT值对分化型甲状腺癌的诊断价值及与淋巴结转移的相关性  

Diagnostic Value of Enhanced CT Signs and CT Values in Differentiated Thyroid Carcinoma and Their Correlation with Lymph Node Metastasis

作　　者：余金超 赵卫燕 王丽丽 Yu Jin-chao;ZHAO Wei-yan;WANG Li-li(Xuancheng People's Hospital,Xuancheng 242000,Anhui Province,China)

机构地区：[1]宣城市人民医院,安徽宣城242000

出　　处：《中国CT和MRI杂志》2025年第4期49-52,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨增强CT征象和CT值对分化型甲状腺癌的诊断价值,并分析其与淋巴结转移的相关性。方法回顾性纳入2021年10月至2023年10月于本院就诊的80例甲状腺癌患者,所有患者入院时均接受增强CT扫描检查,以手术后组织病理检查结果为金标准,分析增强CT扫描检查结果与金标准的一致性。80例甲状腺癌患者共91个病灶,统计病灶淋巴结转移情况,将其分为转移组(44个)与未转移组(47个),对比两组增强CT征象、CT值,采用Logistic回归分析其与甲状腺癌患者淋巴结转移的关系,绘制受试者工作特征曲线(ROC)探讨增强CT征象、CT值对甲状腺癌患者发生淋巴结转移的诊断价值。结果80例甲状腺癌患者增强CT扫描检查阳性率低于病理检查结果(P<0.05);以组织病理检查结果为“金标准”,采用Kappa一致性检验,结果显示,增强CT扫描检查结果与金标准一致性极好(Kappa=0.913,P<0.05);转移组不规则形态率、钙化、坏死、边界不清楚、静脉期CT值高于未转移组(P<0.05);经Logistic回归分析,结果显示,不规则形态(95%CI:1.092-6.105)、钙化(95%CI:1.010-6.124)、坏死(95%CI:1.094-5.938)、边界不清楚(95%CI:1.207-7.051)、静脉期CT值高(95%CI:1.020-1.068)是甲状腺癌患者淋巴结转移的危险因素(OR>1,P<0.05);绘制ROC曲线,结果显示,形态、钙化、坏死、边界、静脉期CT值对甲状腺癌患者淋巴结转移具有一定诊断价值(AUC=0.644、0.631、0.657、0.654、0.745),当静脉期CT值cut-off值取101.145HU时可获得最佳诊断价值。结论增强CT对分化型甲状腺癌具有良好诊断价值,其中形态、钙化、坏死、边界等增强CT征象及静脉期CT值与甲状腺癌患者淋巴结转移密切相关,可用于淋巴结转移的术前诊断。Objective To explore the diagnostic value of enhanced CT signs and CT values in differentiated thyroid carcinoma,and analyze its correlation with lymph node metastasis.Methods Eighty patients with thyroid cancer admitted to our hospital from October 2021 to October 2023 were retrospectively included.All patients received enhanced CT scanning when they were admitted to the hospital.The results of postoperative histopathological examination were taken as the gold standard,and the consistency between the results of enhanced CT scanning and the gold standard was analyzed.There are 91 lesions in 80 patients with thyroid cancer.The lymph node metastasis of the lesions is counted and divided into metastatic group(44)and non-metastatic group(47).The enhanced CT signs and CT values of the two groups are compared,and the relationship between them and lymph node metastasis of thyroid cancer patients is analyzed by Logistic regression.receiver operating characteristic curve(ROC)is drawn to explore the diagnostic value of enhanced CT signs and CT values for lymph node metastasis of thyroid cancer patients.Results The positive rate of enhanced CT scan in 80 patients with thyroid cancer was lower than that of pathological examination(P<0.05).Taking the results of histopathological examination as the gold standard,Kappa consistency test was used.The results showed that the results of enhanced CT scanning were in excellent consistency with the gold standard(Kappa=0.913,P<0.05).The rate of irregular morphology,calcification,necrosis,unclear boundary and CT value in venous phase in metastatic group were higher than those in non-metastatic group(P<0.05).Through logistic regression analysis,the results showed that irregular morphology(95%CI:1.092-6.105),calcification(95%CI:1.010-6.124),necrosis(95%CI:1.094-5.938),unclear boundaries(95%CI:1.207-7.051),and high venous CT values(95%CI:1.020-1.068)were risk factors for lymph node metastasis in thyroid cancer patients.The ROC curve was drawn.The results showed that CT values of morphology

关 键 词：分化型甲状腺癌 增强CT征象 CT值 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]