超声诊断甲状腺癌的敏感度和特异性高于MSCT

  目的  分析甲状腺癌超声和多层螺旋CT(MSCT)扫描的影像学特征并分析其诊断价值。  方法  选取我院2018年1月1日~2021年10月8日收治的349例拟诊为甲状腺癌的患者为研究对象，根据超声检查结果，将患者分为超声恶性组203例和超声良性组146例; 根据MSCT检查结果，分为MSCT恶性组198例和MSCT良性组151例。分析其超声和MSCT影像学特征，并绘制受试者工作特征曲线分析超声和MSCT对甲状腺癌诊断的特异性和敏感度。  结果  超声恶性组与良性组患者在实性结节、低回声、钙化、形态不规则以及边界不清晰的差异有统计学意义(P < 0.05); MSCT恶性组与良性组患者在单发病灶、边界不清晰、形态不规则、钙化、囊变、不均匀强化以及淋巴结肿大的差异有统计学意义(P < 0.05); MSCT扫描诊断甲状腺癌的曲线下面积为0.789，敏感度为75.18%，特异性为82.69%，超声扫描诊断甲状腺癌的曲线下面积为0.862，敏感度为82.98%，特异性为89.42%。  结论  超声诊断甲状腺癌的影像学特征表现为实性结节、低回声、钙化、形态不规则以及边界不清晰等，MSCT诊断甲状腺癌的影像学特征表现为单发病灶、边界不清晰、形态不规则、钙化、囊变、不均匀强化以及淋巴结肿大等; 超声诊断甲状腺癌的特异性和敏感度高于MSCT诊断。 

Characteristics and diagnostic value of ultrasound and MSCT for thyroid cancer

  Objective  To explore the characteristics and diagnostic value of ultrasound and multi-slice spiral CT (MSCT) for thyroid cancer.  Methods  A total of 349 cases of patients suspected of thyroid cancer who were admitted to the hospital between January 1, 2018 and October 8, 2021 were selected. According to the results of ultrasonography, 203 cases were divided into malignant group and 146 cases were divided into benign group. According to the results of MSCT, 198 cases were divided into malignant group and 151 cases were divided into benign group. Their ultrasound and MSCT characteristics were analyzed. The ROC curve was plotted to analyze the specificity and sensitivity of ultrasound and MSCT in the diagnosis of thyroid cancer.  Results  There were significant differences between the malignant group and benign group which were examined by ultrasonography in solid nodules, hypoecho, calcification, irregular morphology and fuzzy boundaries (P < 0.05). There were significant differences between the malignant group and benign group which were examined by MSCT in single lesions, fuzzy boundaries, irregular morphology, calcification, cystic degeneration, heterogeneous enhancement, and enlarged lymph nodes (P < 0.05). The area under the curve value, sensitivity and specificity of MSCT to diagnose thyroid cancer were 0.789, 75.18% and 82.69%, which of ultrasound were 0.862, 82.98% and 89.42%.  Conclusion  The imaging features of thyroid carcinoma diagnosed by ultrasound are solid nodules, hypoechoic, calcification, irregular morphology and fuzzy boundaries. The imaging features of MSCT in the diagnosis of thyroid cancer are single focus, fuzzy boundaries, irregular morphology, calcification, cystic change, uneven enhancement and enlarged lymph nodes. Ultrasound is more specific and sensitive than MSCT in the diagnosis of thyroid cancer.