甲状腺良恶性病变的螺旋CT特征表现及与病理基础的相关性研究

Spiral CT Features of Benign and Malignant Thyroid Lesions and the Correlation with Pathological Basis

目的探讨甲状腺良恶性病变的螺旋CT特征表现及与病理基础的相关性。方法选取2016年1月至2018年1月我院收治的97例甲状腺病变患者为研究对象,经病理检查证实良性病变56例,恶性病变41例。所有患者均进行螺旋CT检查。观察甲状腺良恶性病变的螺旋CT特征表现,通过单因素和Logisitic回归分析其与病理基础的相关性。结果 97例甲状腺病变患者根据螺旋CT各特征表现诊断结果与病理诊断相符的有:良性病变50例,恶性病变36例,与病理诊断结果比较无明显差异(P>0.05),其诊断灵敏度、特异度与准确性分别为87.80%、89.29%和88.66%。对97例甲状腺病变患者各项CT征象进行单因素分析,结果显示病灶数目为单发、病变边界模糊、强化程度低于甲状腺、微钙化、颈淋巴结肿大和咬饼征常见于恶性病变中,而囊变为主和有包膜常见于良性病变中(均P<0.05);病变密度和壁结节在良恶性病变中无明显差异(均P>0.05)。Logisitic回归分析结果进一步显示病变边界模糊、强化程度低于甲状腺、微钙化、颈淋巴结肿大和咬饼征常见于恶性病变中,而囊变为主和有包膜常见于良性病变中(均P<0.05);但病变数目在良恶性病变中无明显差异(P>0.05)。结论螺旋CT检查对甲状腺良、恶性病变具有较高的诊断价值,其中病变边界模糊、强化程度低于甲状腺、微钙化、颈淋巴结肿大和咬饼征等CT特征提示恶性病变可能性大,而囊变为主和有包膜多为良性病变。

Objective To investigate the features of spiral CT in benign and malignant thyroid lesions and their correlation with pathological basis. Methods 97 patients with thyroid disease who were treated in our hospital from January 2016 to January 2018 were selected as subjects. 56 pathological examinations confirmed benign lesions and 41 malignant lesions. All patients were given spiral CT examination. Spiral CT features of benign and malignant thyroid lesions were observed and their association with pathological basis was analyzed by univariate and Logistic regression. Results According to the features of spiral CT, the diagnostic findings of the 97 patients with thyroid disease were consistent with the pathological diagnosis: 50 cases of benign lesions and 36 cases of malignant lesions. There was no significant difference compared with the pathological diagnosis(P>0.05), and the diagnostic sensitivity, specificity and accuracy were 87.80%, 89.29% and 88.66%, respectively. Univariate analysis of CT features in 97 patients with thyroid disease revealed that the number of lesions was single, the lesion boundary was blurred, the degree of enhancement was lower than that of thyroid, microcalcification, cervical lymphadenopathy, and bite cake syndrome were common in malignant lesions, and the cystic predominance and envelope were common in benign lesions(all P<0.05).There was no significant difference in lesion density and mural nodules between benign and malignant lesions(all P>0.05). Logisitic regression analysis further showed that the lesion boundary was blurred, the degree of enhancement was lower than that of thyroid, microcalcification, cervical lymphadenopathy, and bite cake syndrome were common in malignant lesions, and the cystic predominance and envelope were common in benign lesions(all P<0.05). However, there was no significant difference in the number of lesions between benign and malignant lesions(P>0.05). Conclusion Spiral CT examination has high diagnostic value for benign and malignant thyroid lesions. The CT features of lesion boundary is blurred, the enhancement is less than that of thyroid, microcalcification, cervical lymphadenopathy and biting cake suggest that the malignant lesions have a high possibility of cystic degeneration, and the main and covered are mostly benign lesions.