多层螺旋CT在甲状腺良恶性结节的临床鉴别与诊断中的应用

Clinical Application of Multi-slice Spiral CT in the Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的探讨多层螺旋CT在甲状腺良恶性结节的临床鉴别与诊断中的应用价值。方法该研究方便选取2016年2月—2017年2月该院收治的72例甲状腺结节患者采用多层螺旋CT进行扫描检查,分析多层螺旋CT的特征表现及强化特征,并与病理确诊结果进行对比分析。结果多层螺旋CT对甲状腺良恶性结节的鉴别与诊断结果与病理确诊的结果(100.00%VS 97.22%)进行对比发现两种方法差异无统计学意义(χ~2=0.68,P>0.05)。良性组与恶性组在形态(16.67%VS 88.89%)、边界(20.37%VS 94.44%)、钙化(31.48%VS 66.67%)、囊变(48.15%VS 83.33%)等CT特征表现方面比较差异有统计学意义(χ~2=9.84、9.72、4.37、5.06,P<0.05)。良性组与恶性组在均匀强化(68.52%VS 5.56%)、完整环形强化(42.59%VS 5.56%)、瘤周强化残圈(0.00%VS 50.00%)、半岛样强化(1.85%VS 27.78%)等强化特征方面比较差异有统计学意义(χ~2=7.68、6.59、4.18、4.01,P<0.05)。结论多层螺旋CT检查在甲状腺良恶性结节的鉴别诊断中具有重要的临床应用价值,对良恶性结节各自具有一定特征性,但是由于多数征象不具特异性,所以需要结合临床综合征象,才能准确判断,这有利于临床制定治疗方式及预后判断,值得临床推广使用。

Objective This paper tries to investigate the clinical value of multi-slice spiral CT in the differential diagnosis and diagnosis of benign and malignant thyroid nodules. Methods From February 2016 to February 2017, 72 cases of thyroid nodules were conveniently selected and diagnosed by multi-slice spiral CT scan, and the enhancement characteristics of multi-slice spiral CT were analyzed. The results were compared with pathology results. Results The differentiation and diagnosis of benign and malignant thyroid nodules with multi-slice spiral CT and the results of pathological diagnosis were100.00% and 97.22%. The results showed that there was no significant difference between the two methods（χ~2=0.68, P〈0.05）. The benign and malignant groups had obvious difference in morphology（16.67% vs 88.89%）, border（20.37% vs94.44%）, calcification（31.48% vs 66.67%）, cystic change（48.15% vs 83.33%） and other CT features（χ~2=9.84, 9.72, 4.37,5.06, P〈0.05）. Homogeneous enhancement in the benign group and the malignant group were（68.52% vs 5.56%）, complete ring enhancement（42.59% vs 5.56%）, peritumoral enhancement residual circle（0.00% vs 50.00%）, the peninsula enhancement（1.85% vs 27.78%）, with relatively obvious difference（χ~2=7.68, 6.59, 4.18, 4.01, P〈0.05）. Conclusion Multi-slice spiral CT examination plays an important clinical role in differential diagnosis of benign and malignant thyroid nodules;both have certain characteristics of benign and malignant nodules. But, because most signs are not specific, clinical signs should be combined with to accurately judge, which is conducive to the development of clinical treatment and prognosis. It is worthy of clinical use.