不同病理类型甲状腺恶性肿瘤的能谱参数初步研究

Preliminary study on spectral parameters of various pathological types of thyroid malignancies

目的分析不同病理类型的甲状腺恶性肿瘤的影像表现及能谱参数。方法回顾性分析67例甲状腺恶性肿瘤的形态学表现及能谱参数。采用Discovery CT750HD CT扫描机能谱模式扫描,在最佳单能量影像上对病灶进行形态学征象分析。应用能谱分析与测量软件对不同病理类型病灶的碘含量(IC)、水含量(WC)、标化碘含量(NIC)、能谱曲线斜率(K)等参数进行计算和分析,采用单因素方差分析对不同病理类型的病灶能谱参数进行比较,组间多重比较采用LSD-t法。结果甲状腺恶性肿瘤形态学表现为单发57例(85.1%),形态不规则46例(68.7%),边界不清楚45例(67.2%),密度不均匀48例(71.6%),21例(31.3%)可见钙化灶。不同病理类型的甲状腺恶性肿瘤的病灶WC间差异无统计学意义(P>0.05)。乳头状癌、滤泡癌、髓样癌的IC、NIC及K值均高于未分化癌和淋巴瘤(P<0.05)。结论不同病理类型甲状腺恶性肿瘤形态学表现及能谱参数有一定差异,了解其差异有助于该类病变的诊断及鉴别诊断。

Objective To analyze the imaging manifestations and spectral parameters of various pathological types of thyroid malignancies. Methods Sixty-seven cases with malignant tumors of thyroid were included in the present retrospective study. The morphological manifestations and the spectral parameters were analyzed. All the patients underwent spectral CT scan with Discovery CT750 HD scanner in gemstone spectral imaging （GSI） mode. The morphological manifestations of lesions were analyzed on the optimal monochromatic images. The iodine concentration （IC）, water concentration （WC）, normalized iodine concentration （NIC）, and spectral HU curve slope （K） were measured and analyzed with GSI Viewer. The spectral parameters of different pathological types of lesions were compared using One-Way ANOVA. Multiple comparisons between groups were performed using LSD-t. Results The morphological features of thyroid malignancies were as follows：single lesion （57 cases, 85.1%）, irregular shape （46 cases, 68.7%）, indistinct margin （45 cases, 67.2%）, heterogeneous density （48 cases, 71.6%）, and presence of calcification （21 cases, 31.3%）. There was no significant difference in WC among various types of malignant tumors （P〉0.05）. The IC, NIC, and K values of papillary carcinoma, follicular carcinoma, and medullary carcinoma were higher than that of anaplastic carcinoma and lymphoma （P〈0.05）. The NIC of papillary carcinoma was lower than that of medullary carcinoma （P〈0.05）.There were no significant differences in remained parameters between each paired two groups （P〉0.05）. Conclusion The morphological features and spectrum parameters are different in various pathological types of thyroid malignanies, and are helpful for the diagnosis and differential diagnosis.