甲状腺恶性肿瘤CT诊断与触诊的对比研究

目的：评价CT和临床触诊对甲状腺恶性肿瘤的诊断价值。方法：30例甲状腺恶性肿瘤术前均进行CT扫描和临床触诊检查，双盲法观察及分析影像所见，将其结果用卡方检验做统计学处理。结果：30例甲状腺恶性肿瘤中CT和触诊的确诊率分别为80％和43．3％。CT可确诊11例经触诊无法明确的病变，经统计学分析，有显著性差异（X^2＝4．23，P＜0．05）。CT能准确显示肿瘤向周围结构侵犯。在诊断颈部转移性淋巴结的价值上，CT的敏感性、特异性和准确性均优于临床触诊（P＜0．05）。结论：CT对甲状腺恶性肿瘤的术前定性诊断有较大的价值。CT在显示肿瘤向周围结构侵犯和局部淋巴结转移上明显优于临床诊断。同时联合多种诊断技术和综合分析对甲状腺恶性肿瘤的定性诊断、术式选择及预后具有重要的意义。

Comparison study of CT and physical palpation in diagnosis of thyroid carcinoma

Objective: To evaluate the value of CT and physical palpation in the diagnosis of thyroid carcinoma. Methods: Thirty cases with thyroid carcinoma were studied double blindly by CT scan and palpation preoperatively. The results were correlated with pathologic findings and X2 test was used for statistical analysis. Results: The diagnostic rate of CT scan and palpation in thyroid carci- noma were 80% and 43. 3% respectively. In 11 cases CT discovered the mass, but was found negative by palpation. By comparison, there was a significant difference on diagnostic rate between the two groups(X2= 4. 23, P<0. 05). CT accurately showed tumor spread to the surrounding structures. The sensitivity, specificity and accuracy of CT was superior to those of palpation in ascertaining cervical lymph node metastasis, there were significant differencs statistically(p<0. 05). Conclusion: CT scan had a significant value in differen- tial diagnosis in thyroid carcinoma. CT was superior to palpation in showing tumor spread to the surrounding structures and ascertaining certvical lymph node metastasis. Combined multiple imaging technology and analysis had a significant value in diagnosis, therapy plan- ning and prognosis of thyroid carcinoma.