甲状腺良恶性病变的双源CT能谱特征分析

Study on features of dual source CT energy spectrum of benign and malignant thyroid lesions

目的分析甲状腺癌及结节性甲状腺肿的双源CT能谱曲线及碘图特点,为甲状腺良恶性病变的鉴别诊断提供依据。方法回顾性分析2014年1月至2015年8月进行双源CT检查,并经临床手术病理确诊甲状腺癌及结节性甲状腺肿患者55例的临床及影像资料,其中甲状腺癌20例,结节性甲状腺肿35例。所有患者均行西门子双源炫速CT双能量平扫、动脉期及静脉期扫描,应用liver VNC和Monoenergetic软件得到病变区域碘浓度、碘图及能谱曲线,比较甲状腺癌与结节性甲状腺肿患者的能谱曲线斜率、碘浓度。结果平扫甲状腺癌患者的能谱曲线斜率及碘浓度低于结节性甲状腺肿患者,差异均有统计学意义(P均<0.01);动脉期甲状腺癌患者的能谱曲线斜率、甲状腺与颈总动脉碘浓度比值均低于结节性甲状腺肿患者,差异均有统计学意义(P均<0.01);静脉期甲状腺癌患者的能谱曲线斜率、甲状腺与颈总动脉碘浓度比值与结节性甲状腺肿患者比较,差异均无统计学意义(P均>0.05)。结论双源CT双能量定量参数测定可以对甲状腺良恶性病变的鉴别诊断提供依据,提高诊断准确率。

Objective To analyze the characteristics of dual source CT energy spectrum curve and iodine maps of thyroid cancer and nodular goiter to provide a basis for the differential diagnosis of benign and malignant thyroid lesions. Methods Retrospective analysis was performed on clinical and image data of 20 thyroid cancer patients and 35 nodular goiter patients who were checked by dual source CT and get the definite diagnosis by clinical operation and pathology between January 2014 and August 2015. Siemens Hyun speed dual source dual energy CT routine scan,arterial phase and venous phase scans were performed in all patients,and liver VNC and Monoenergetic softwares were applied for getting energy spectrum curve and iodine maps of lesion area. The energy spectrum curve slope and iodine concentration of thyroid cancer and nodular goiter patients were compared. Results During routine scan,the energy spectrum curve slope and the thyroid gland iodine concentration in thyroid cancer patients were significantly lower than those in nodular goiter patients（ all P〈0. 01）.During arterial phase scan,the energy spectrum curve slope and the ratio of thyroid gland iodine concentration to common carotid artery iodine concentration in thyroid cancer patients were significantly lower than those in nodular goiter patients（ all P〈0. 01）. In venous phase scan,there were no significant differences in energy spectrum curve slope and the ratio of thyroid gland iodine concentration to common carotid artery iodine concentration between thyroid cancer patients and nodular goiter patients（ all P〈0. 05）. Conclusion The detection of dual energy quantitative parameters of dual source CT can provide a basis for the differential diagnosis of benign and malignant thyroid lesions and increase the diagnostic accuracy.