甲状腺良恶性结节的CT鉴别诊断

CT differential diagnosis of benign and malignant thyroid nodules

目的:分析甲状腺结节的CT表现,探讨CT扫描在甲状腺良恶性结节鉴别诊断中的价值。方法:对照回顾性分析108例(120个结节)甲状腺结节的CT表现,包括结节的边缘、密度、钙化、包膜、强化方式、强化程度等,比较良恶性结节之间的差异并与病理结果进行对比分析。结果:在结节边缘、微小钙化、包膜、结节数量等方面,良恶性结节之间差异有统计学意义(P<0.05),结节边缘不清、微小钙化、无包膜、病灶单发对恶性结节诊断的敏感度分别为45.5%、36.4%、100%、90.9%,特异度分别为83.7%、94.9%、22.4%、36.0%,准确度分别为83.6%、91.8%、36.7%、48.1%。结论:甲状腺良恶性结节的CT表现有一定特征性,边缘不清和微小钙化是甲状腺恶性结节的特征性征象,完整包膜和囊性结节是良性结节的特征性征象。

Objective：To analyze the CT features of thyroid nodules,in order to assess the value of CT in the diffe-rential diagnosis of benign and malignant lesions.Methods：The CT findings including margin,attenuation,calcification,capsule as well as the mode and the degree of enhancement of 120 thyroid nodules（108 patients） were retrospectively analyzed and correlated with pathology,the differences of benign or malignant nodules were compared.Results：Significant statistical differences were existed between benign/malignant nodules in the aspects of ill-defined margin,micro-calcifications,encapsulation and the number of nodules（P〈0.05）.For the diagnosis of malignant nodule,the sensitivity of ill-defined margin,existence of micro-calcifications,non-capsulation and solitary in number was 45.5%,36.4%,100%,90.9% respectively,the specificity was 83.7%、94.9%、22.4%、36.0% respectively,and the accuracy was 83.6%、91.8%、36.7%、48.1% respectively.Conclusion：Certain imaging characteristics were assessed in benign and malignant thyroid nodules,ill-defined margin and micro-calcifications are the characteristic features of malignant nodules;well-capsulation and cystic components are the characteristic features of benign nodules.