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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (3): 81-86.doi: 10.6040/j.issn.1671-7554.0.2015.263

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宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析

李进叶1,宋歌声2,宋吉清3,王大伟2,靳先文4,张成琪2   

  1. 1.山东大学医学院, 山东 济南 250012;2. 山东大学附属千佛山医院影像科, 山东 济南 250014;3. 山东大学附属省立医院影像科, 山东 济南 250021;4. 泰山医学院放射学院, 山东 泰安 271016
  • 收稿日期:2015-03-11 出版日期:2016-03-10 发布日期:2016-03-10
  • 通讯作者: 张成琪. E-mail:chengqizhangsd@126.com E-mail:chengqizhangsd@126.com

Comparative study of gemstone spectral CT and conventional ultrasound spectroscopy for the diagnosis of benign and malignant thyroid nodules

LI Jinye1, SONG Gesheng2, SONG Jiqing3, WANG Dawei2, JIN Xianwen4, ZHANG Chengqi2   

  1. 1. School of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Medical Imaging, Qianfoshan Hospital Affilicated to Shandong University, Jinan 250014, Shandong, China;
    3. Department of Medical Imaging, Shandong Provincial Hospital Affilicated to Shandong University, Jinan 250021, Shandong, China;
    4. College of Radiology, Taishan Medical College, Taian 271016, Shandong, China
  • Received:2015-03-11 Online:2016-03-10 Published:2016-03-10

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摘要： 目的 探讨宝石能谱CT对甲状腺结节良恶性的诊断价值,并与超声结果对照。 方法 回顾性分析经病理证实的44个甲状腺结节的能谱CT和超声图像,所有患者均行颈部能谱CT平扫、动脉期扫描及超声检查,根据病理结果,分为良性组和恶性组。能谱数据采用独立样本t检验或非参数检验,超声图像采用多因素Logistic回归分析。绘制受试者工作特征(ROC)曲线,得出最佳诊断阈值、敏感性和特异性。 结果 良性组23个,恶性组21个。两组碘浓度、标准化碘浓度、能谱曲线斜率均值平扫期差异有统计学意义(P<0.05),动脉期差异无统计学意义(P>0.05)。平扫期诊断甲状腺恶性结节最佳碘浓度值为0.32×100 μg/mL,敏感度为100%,特异度为79.5%。超声图像中结节的形态、边界、囊变情况在良恶性结节之间的差异有统计学意义(P<0.05),敏感度为84.2%,特异度为68.1%。 结论 能谱CT平扫对甲状腺结节良恶性诊断有一定价值,在直径≥1 cm的结节中其诊断效能优于超声。

关键词: 甲状腺结节, 超声检查, 宝石能谱CT, 鉴别诊断

Abstract: Objective To explore the value of the gemstone spectral CT imaging in differential diagnosis of benign and malignant thyroid nodules,and compare its diagnostic value with ultrasonography. Methods Forty-four thyroid nodules were analyzed retrospectively. All patients underwent gemstone spectral CT scanning, arterial phase enhanced CT imaging and ultrasonography. According to the pathology results, nodules were divided into benign group and malignant group. Data of spectral CT imaging and ultrasonography were analyzed by independent sample t test or nonparametric test and multivariate Logistic regression analysis respectively. The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic(ROC)curve, and the sensitivity and specificity were achieved. Results A total of 44 nodules were detected, including 23 benign and 21 malignant nodules. Between the two groups, there was difference of the average iodine concentration, standardized iodine concentration, and slope of spectral curve in non-contrast CT imaging(P<0.05), while there was no difference in the arterial phase(P>0.05). The optimal iodine concentration to predict malignancy was 0.32×100 μg/mL in non-enhanced phase with 100% sensitivity and 79.5%specificity. The nodules form, border, cystic situation between the two groups were statistically different in ultrasonography with multivariate logistic regression analysis(P<0.05). The sensitivity and specificity was 山 东 大 学 学 报 (医 学 版)54卷3期 -李进叶,等.宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析 \=-84.2% and 68.1%, respectively. Conclusion Gemstone spectral CT imaging in non-contrast phase has potential value in diagnosis of benign and malignant thyroid nodules, and is better than that of ultrasonic in diagnosis of the nodules whose diameter great than or equal to 1 cm.

Key words: Thyroid nodule, Ultrasonography, Gemstone spectral CT, Differential diagnosis

中图分类号: 

  • R445.3
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