高分辨率超声联合CT对肿瘤性甲状腺结节的定性诊断价值

Image finding and diagnostic value of combination of high resolution ultrasound and CT in tumor of thyroid nodules

目的探讨高分辨率超声联合CT对肿瘤性甲状腺结节的诊断价值。方法选择2011年9月至2014年2月我院收治的术前MSCT和手术病理证实的178例甲状腺结节患者,分别采用高分辨率超声和CT检查,比较单用超声、单用CT和超声联合CT对结节的良恶性进行诊断。结果单用CT在观察甲状腺结节侵袭被膜、钙化灶方面优于单用超声,而在观察结节边界方面较差(P<0.05);二者联合观察结节边界、侵袭被膜、钙化灶方面均优于单用超声或CT(P<0.05)。单用超声对肿瘤性甲状腺结节良、恶性的最佳诊断阈值为4.8,此时敏感度为81.56%、特异性为79.33%、准确性为81.90%;单用CT超声对肿瘤性甲状腺结节良、恶性的最佳诊断界值为2.0,此时敏感度为83.51%、特异性为80.24%、准确性为84.17%;以超声4.8和CT 2.0为诊断界值,超声联合CT诊断的敏感度为79.91%、特异性为91.63%、准确性为88.45%。结论高分辨率超声检查联合CT在诊断肿瘤性甲状腺结节上具有很好的特异性、敏感度和准确性,可广泛应用于临床。

Objective To explore the image finding and diagnostic value of combined high resolution ultrasound and CT in tumor of thyroid nodules. Methods One hundred seventy-eight patients with thyroid nodules from September 2011 to February 2014 in our hospital were selected. Their thyroid nodules were confirmed by pathology and muhisice computed tomography （MSCT）. These pa- tients were further examined with high resolution ultrasound and CT respectively. Diagnostic values for benign and malignant nodules were compared among ultrasound alone, CT alone and combination of the two methods. Results Compared with ultrasound alone, CT a- lone was better in invasion by membrane and calcification of thyroid nodules but worse in observing nodule boundary （ P 〈 0. 05 ）. Com- pared with ultrasound alone or CT alone, combination of the two methods was better in observing nodule boundary, invasion by mem- brane and calcification （P 〈 0. 05）. The best diagnostic threshold of ultrasound alone was 4. 8. Its sensitivity, specificity and accuracy were 81.56% ,79. 33% and 81.90% , respectively. The best diagnostic threshold of CT alone was 2. 0. Its sensitivity, specificity and ac- curacy were 83.51% ,80. 24% and 84. 17% ,respectively. Based upon the best diagnostic threshold of ultrasound and CT,the sensitivi- ty ,specificity and accuracy of combination of the two methods were 79.91% ,91.63% and 88.45% ,respectively. Conclusion Combi- nation of high resolution ultrasound and CT has high sensitivity, specificity and accuracy in diagnosis of tumor of thyroid nodules. It can be widely used in clinical application.