能谱CT钙基图像对甲状腺良恶性结节的鉴别诊断价值

目的 探讨能谱CT钙基图像定量分析对甲状腺良恶性结节的鉴别诊断价值.方法 收集经手术病理证实的82例甲状腺结节患者(共98个结节),所有患者术前均行甲状腺能谱CT平扫及双期增强扫描.根据病理结果,将甲状腺结节分为恶性组(61个)和良性组(37个),另选50例患者的对侧正常甲状腺组织作为正常组,比较3组平扫期钙浓度的差异.绘制受试者工作特征(ROC)曲线,得出最佳诊断阈值及诊断的敏感度和特异度.结果 恶性组、良性组和正常组的平扫期钙浓度(mg/cm3)分别为5.52±2.72、10.72±4.68和24.66±7.58,两两比较差异均有统计学意义(P值均<0.001).平扫期诊断甲状腺恶性结节的最佳钙浓度值为6.065 mg/cm3,敏感度为65.6%,特异度为91.9%.结论 能谱CT能够定量评估甲状腺结节的钙浓度,对鉴别甲状腺良恶性结节有一定价值.

Value of calcium-based quantitative spectral CT imaging in differential diagnosis of benign and malignant thyroid nodules

Objective To evaluate the value of calcium-based quantitative spectral CT imaging in differential diagnosis of benign and malignant thyroid nodules.Methods Totally 82 patients with 98 thyroid nodules confirmed by pathology underwent unenhanced and dual-phase enhanced spectral CT scans before operation.Thyroid nodules were divided into malignant group (61 nodules) and benign group (37 nodules),according to histopathologic results.Besides,contralateral normal thyroid tissue of 50 patients was selected as normal group.The calcium concentration of malignant,benign and normal group in non-enhanced scanning was analysed.The optimal threshold to predict malignancy and the corresponding diagnostic sensitivity and specificity were obtained by ROC curve.Results The calcium concentrations for malignant, benign and normal group in non-enhanced scanning were (5.52±2.72) mg/cm3, (10.72±4.68) mg/cm3 and (24.66±7.58) mg/cm3 respectively.There were significant differences statistically in any two groups (P<0.001).For malignant thyroid nodules, the best diagnostic threshold of calcium concentration was 6.065 mg/cm3,and the diagnostic sensitivity and specificity were 65.6% and 91.9% respectively.Conclusion Spectral CT imaging can quantitatively assess the calcium concentration of thyroid nodules,which provides promising quantitative approach for distinguishing malignant thyroid nodules from benign nodules.