良恶性甲状腺结节的DSCT诊断与鉴别诊断

目的:探讨良恶性甲状腺结节的DSCT诊断与鉴别诊断价值。方法:回顾性分析78例经手术病理证实的甲状腺结节的DSCT 表现，所有患者均行双源双能量CT平扫及增强扫描。结果:甲状腺恶性结节多表现为形态不规则、边界不清、微小钙化和“强化残圈征”，与良性结节均有统计学差异（P＜0.05）。在双源双能量CT上，甲状腺良性结节的碘含量明显高于恶性结节（P＜0.05）。双源双能量CT能谱曲线上，良性结节均表现为“下降型”，56.3%的恶性结节能谱曲线表现为“上升型”（P＜0.05），43.8%表现为“下降型”。结论:DSCT对诊断和鉴别诊断良恶性甲状腺结节具有重要的价值。

Dual-source dual-energy CT diagnosis in distinguishing benign and malignant thyroid nodules

Objective:To explore the diagnosis value of the dual-energy dual-source CT(DSCT) of thyroid nodules to distinguish benign and malignant thyroid nodules.Methods:Dual-energy DSCT manifestations of 78 cases of the thyroid nodules confirmed by operation and pathology were retrospectively analyzed．All cases were performed routine non-enhanced scan using DSCT with dual energy mode,then underwent the enhanced scanning with dual energy mode after injection of iodinated contrast material.Results:Malignant nodules were more often showed irregular shape,obscure boundary,contained micro-calcification，showed no complete enhanced ring around the tumor.Differences of the DSCT characteristics between the benign and malignant nodules of the thyroid gland showed statistical significance (P＜0.05).Iodine content between the benign and malignant thyroid nodules in nonenhanced weighted images showed statistical significance(P＜0.05).Iodine content of benign thyroid nodules is more than that of malignant thyroid nodules.Energy spectrum curve of benign thyroid nodules mainly represent as "descent model".Energy spcetrum curve of malignant thyroid nodules represent as either "rise model"（56.3%）or "descent model"（43.8%）.Curve model between the benign and malignant thyroid nodules in nonenhanced weighted images showed statistical significance (P＜0.05).Conclusion:The dual-energy DSCT has important diagnostic value and differential diagnosis for the benign and malignant thyroid nodules.