CT灌注成像在甲状腺良恶性结节鉴别诊断中的价值

The value of CT perfusion in differential diagnosis between thyroid benign and malignant nodules

目的:探讨CT灌注成像在甲状腺良恶性结节鉴别诊断中的价值。方法:选取40例甲状腺病变患者,良性组32例(24例甲状腺肿、8例甲状腺腺瘤),恶性组8例,均采用常规CT平扫和同层动态灌注扫描,计算出血流量(BF)、血容量(BV)、表面通透性(PS)、平均通过时间(MTT)、达峰时间(TTP),比较两组患者各种灌注参数的差异。结果:良性组BF、BV、PS、MTT及TTP值分别为(126.9±11.58)ml/(100g.min)、(35.19±2.73)ml/100g、(35.70±2.35)ml/(100g.min)、(8.41±0.92)s、(16.47±1.66)s;恶性组分别为(66.32±4.68)ml/(100g.min)、(23.23±3.88)ml/100g、(38.12±2.08)ml/(100g.min)、(15.22±0.26)s、(10.89±0.87)s。良性组与恶性组各灌注参数比较,BF和MTT差异有统计学意义(P<0.05),其它参数之间差异均无统计学意义;良性组结节之间灌注参数差异均无统计学意义(P>0.05)。结论:CT灌注成像可对甲状腺结节微血管血流动力学状况进行量化评估,通过分析各种灌注参数的差异,对甲状腺良恶性病变的鉴别诊断有重要的价值。

Objective：To assess the value of CT perfusion in differentiating benign and malignant thyroid nodules. Methods： All 40 patients with thyroid nodule,including benign eases （n=32）,and malignant cases （n=8）, underwent routine and dynamic contrast enhanced CT scanning. We calculated the perfusion parameters,including the blood flow （BF）, blood volume （BV）,permeability surface area product （PS）,mean transit time （MTT） and time to peak （TTP）,and compared differenee of the two groups perfusion parameters. Results： The mean values of BF, BV, PS, MTT and TTP in of the benign group were （126.9±11.58）ml/（100g.min）, （35. 19±2. 73）ml/100g, （35. 70±2.35）ml/（100g. min）, （8. 41± 0.92） s and （16.47 ±1.66）s, respectively. The mean values of BF, BV, PS, MTT and TTP of the malignant group were （66.32±4.68）ml/（100g.min）,（23. 23±3.88）ml/100g,（38.12±2.08）ml/（100g.min）, （15.22±0.26）s and （10.89± 0.87）s, respectively. There was significant difference of BF and MTT between the two groups （P〈0.05） ,but there was no significant difference of the other parameters between the two groups （P〉0. 05）. There was also not significant difference of the parameters in the benign group （P〉0.05）. Conclusion： CT perfusion imaging of thyroid could show microvascular hemodynamie and perfusion parameters which may differentiate thyroid benign and malignant lesions.