多层螺旋CT灌注成像在甲状腺疾病诊断中的临床价值

The clinical value of multi-slice spiral CT perfusion imaging in diagnosis of thyroid diseases

目的探讨多层螺旋CT灌注成像在甲状腺疾病诊断中的临床应用价值。方法选取2011年1月∽2014年12月我院收治的甲状腺疾病患者112例,作为研究对象。所有患者均以甲状腺疾病拟手术治疗术前进行甲状腺螺旋CT平扫、血管灌注成像及彩色多普勒超声检查,对比CT与超声的诊断结果并比较螺旋CT血管灌注成像在鉴别诊断甲状腺良恶性病变中的应用效果及影像特点。结果以手术所见及病理实验结果作为金标准,CT组检出甲状腺良性病变58例,恶性病变49例,确诊率达95.54%,确诊率明显高于超声组,并且与病理证实结果比较差异无统计学意义（P〉0.05）;对比良恶性甲状腺病变CT灌注参数可知,良恶性病变的血容量（BV）及血流量（BF）比较差异无统计学意,但灌注达峰时间（TTP）与毛细血管表面通透性（PS）指标比较存在差异有统计学意义（P〈0.05）。结论多层螺旋CT血管灌注成像用于诊断甲状腺疾病具有较高的敏感性与特异性,并且根据病变灌注参数及影像差异可准确鉴别甲状腺疾病的良恶形式,具有临床应用及推广价值。

ObjectiveTo investigate the clinical application value of multi-slice spiral CT perfusion imaging in diagnosis of thyroid diseases.Methods 112 patients with thyroid diseases in our hospital from January 2011 to December 2014 were selected as the research object. All patients with thyroid disease preoperatively received thyroid spiral CT scan, perfusion imaging and color Doppler ultrasonography, diagnosis and comparison of CT and ultrasound results and comparison of application effect in the differential diagnosis of benign and malignant thyroid lesions and imaging characteristics of spiral CT perfusion imaging.ResultsThe operation findings and pathology results was the gold standard, CT group detected thyroid benign lesions in 58 cases, 49 cases of malignant lesions, diagnosis rate was 95.54%, the diagnosis rate was significantly higher than the ultrasound group, and no significant difference compared with pathology results（P〉0.05）, has no statistical significance; Comparison of benign and malignant thyroid lesions of CT perfusion parameters known, benign and malignant lesions of blood volume （BV） and blood flow （BF） showed no significant difference, but the perfusion time to peak （TTP） and capillary permeability surface （PS） index comparison had the remarkable difference（P〈0.05）, was statistically significant.Conclusion The sensitivity and specificity for the diagnosis of thyroid diseases with high multi-slice spiral CT perfusion imaging and blood vessels, according to the pathological perfusion parameters and image difference can be accurately distinguish benign and malignant thyroid disease form, has the clinical value of application and popularization.