高分辨率CT增强扫描在老年甲状腺结节良及恶性诊断中的价值

The Value of High Resolution CT Enhanced Scan in the Differential Diagnosis of Benign and Malignant Thyroid Nodules in the Elderly

目的探讨高分辨率CT增强扫描在老年甲状腺结节患者的结节良、恶性鉴别诊断中的价值,为合理选择手术方式及预后评估提供依据。方法回顾性分析2017年5月—2019年4月在上海中医药大学附属曙光医院收治的经组织病理学证实的老年甲状腺单发结节患者86例的高分辨率CT扫描资料,根据病理结果分为良性结节组(43例)与恶性结节组(43例),分析各CT征象,包括结节的大小、密度、强化幅度、强化方式、囊变、边缘、包膜及钙化情况。结果老年患者甲状腺良、恶性结节在结节强化方式、边缘中断、假包膜及细颗粒状钙化方面差异有统计学意义(P<0.05);在结节大小、密度、强化幅度和囊变方面差异无统计学意义(P>0.05)。结论高分辨率CT增强检查在老年患者甲状腺结节的良、恶性鉴别方面具有重要价值。结节不均匀强化、边缘中断征、假包膜征及细颗粒状钙化提示老年甲状腺恶性结节诊断。

Objective To explore the value of high resolution CT enhanced scan in the differential diagnosis of benign and malignant thyroid nodules in the elderly.Methods The high resolution CT scan data of 86 elderly patients with single thyroid nodule confirmed by histopathology admitted to Shuguang hospital from May 2017 to April 2019 were analyzed retrospectively.According to the pathological results,they were divided into benign nodule group(43 cases)and malignant nodule group(43 cases).The CT features of the two groups were analyzed and compared,including the size,density,enhancement amplitude,enhancement mode,cystic change,edge,capsule,and calcification of the nodules.Results There were significant differences between benign and malignant thyroid nodules in the CT signs of the enhancement mode,edge interruption,pseudocapsule and fine granular calcification(P<0.05),but there was not any significant difference(P>0.05)in the CT signs of the size,density,cystic degeneration and enhancement amplitude.Conclusion High resolution CT enhanced scan is of great value in differentiating benign from malignant thyroid nodules in elderly patients.Heterogeneous enhancement,borderline interruption,pseudocapsule and fine granular calcification of thyroid nodules suggest the diagnosis of malignant thyroid nodules in the elderly.