CT值鉴别甲状腺钙化病变良恶性的价值研究

目的 探讨CT值在鉴别诊断甲状腺良恶性钙化病变中的价值。方法 回归性分析经过病理证实的甲状腺良性钙化48例及恶性钙化26例的CT平扫资料，并对74例甲状腺钙化进行CT值测量。通过绘制受试者操作特征(receiver operator characteristic,ROC)曲线确定鉴别甲状腺良恶性钙化的最佳阈值及ROC曲线下最大面积，并算出相应的特异性、敏感度、阳性预测值、阴性预测值、假阳性率、假阴性率、准确度和约登指数。然后以最佳阈值作为鉴别诊断甲状腺良恶性钙化的参数，通过χ²检验分析甲状腺良恶性钙化在CT灰度值方面的差异有统计学意义。结果 ROC曲线下方面积为0.814,95%CI:0.712～0.915，当CT值为869.5HU(为计算方便取870HU)时，特异性为69.2%，敏感度为81.3%，阳性预测值为64.3%，阴性预测值为82.6%，假阳性率为20.8%，假阴性率为30.8%，准确度为75.7%，约登指数最大为0.505。当以870HU为鉴别诊断甲状腺良恶性钙化参数时差异有统计学意义(χ²=16.795,P<0.001)。...

Value of CT value in differentiating benign and malignant thyroid calcification

Objective To investigate the value of CT value in differential diagnosis of benign and malignant thyroid calcification. Methods The CT plain scan data of 48 cases of thyroid benign calcification and 26 cases of thyroid malignant calcification confirmed by pathology were analyzed retrospectively, and the CT values of 74 cases of thyroid calcification were measured. The best threshold and the maximum area under the receiver operator characteristic (ROC) curve for differentiating benign and malignant thyroid calcification were determined by plotting ROC curve, and the corresponding specificity, sensitivity, positive predictive value, negative predictive value, false positive rate, false negative rate, accuracy and Jordan index were calculated. Then the optimal threshold value was used as a parameter for differential diagnosis of benign and malignant thyroid calcification, and we adoptted χ2 analyze the statistical difference between benign and malignant thyroid calcification in CT gray value. Results The area under the ROC curve was 0.814, and the 95% confidence interval (CI) was 0.712-0.915. When the CT value was 869.5HU (for the convenience of 870HU), the specificity was 69.2%, the sensitivity was 81.3%, the positive predictive value was 64.3%, the negative predictive value was 82.6%, the false positive rate was 20.8%, and the false negative rate was 30.8%, the accuracy was 75.7% and the maximum of the Youden index was 0.505. When 870HU was taken as the differential diagnosis parameter of thyroid benign and malignant calcification (χ2=16.795, P<0.001). Conclusion When the CT value is 870HU, it has important value in differential diagnosis of benign and malignant thyroid calcification.