超声、MSCT鉴别甲状腺良恶性结节效能的临床研究

Clinical Study on Efficacy of Ultrasound and MSCT in the Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的研究超声、多层螺旋CT(MSCT)鉴别甲状腺良恶性结节的效能。方法回顾性分析医院2016年01至2018年12月间收治的62例甲状腺局灶性病变患者的影像学资料,以病理检查结果为金标准,比较超声及MSCT在诊断甲状腺良恶性肿瘤中的价值。结果病理检查结果提示,62例甲状腺局灶性病变者中单发病变54例,多发病变8例,其中良性病变34例,恶性病变28例;甲状腺恶性病变在MSCT增强扫描中"半岛样"强化及"边缘中断征"较良性病变多(P<0.05);超声检查提示,甲状腺良恶性病变内部回声、边缘形态及纵横比均存在显著性差异(P<0.05);MSCT钙化及沙砾状钙化检出率均显著高于超声(P<0.05);MSCT在鉴别甲状腺恶性肿瘤中的灵敏度、特异度、准确度分别为91.18%、82.14%、87.10%,超声在鉴别甲状腺恶性肿瘤中的灵敏度、特异度、准确度分别为85.29%、75.00%、80.65%。结论超声是目前筛查甲状腺病变的主要方式,能有效提示结节内部回声及边缘形态等信息,而MSCT在提示结节内部钙化及沙砾状钙化中具有优势,有利于提高恶性结节筛查价值。

Objective To study the efficacy of ultrasound and multi-slice spiral CT(MSCT)in the differential diagnosis of benign and malignant thyroid nodules.Methods The imaging data of 62 patients with focal thyroid lesions admitted fromJanuary 2016to December 2018 were analyzedretrospectively.The results of pathological examination were used as the gold standard to compare the value of ultrasound and MSCT in the diagnosis of benign and malignant thyroid tumors.Results The results of pathological examination showed that there were 54 cases of single lesions and 8 cases of multiple lesions among 62 cases of focal thyroid lesions,including 34 benign lesions and 28 malignant lesions.In MSCT enhanced scan,the peninsula-like enhancement and marginal interruption were more common in malignant thyroid lesions than benign lesions(P<0.05).Ultrasound examination showed that there were no significant differences in the internal echo,marginal morphology and aspect ratio between benign and malignant thyroid lesions(P<0.05).The detection rates of calcification and gravel calcification of MSCTwere significantly higher than those of ultrasound(P<0.05).The sensitivity,specificity and accuracy of MSCT in identifying malignant thyroid tumors were 91.18%,82.14%and 87.10%respectively,and the sensitivity,specificity and accuracy of ultrasound in identifying malignant thyroid tumors were 85.29%,75.00%and 80.65%respectively.Conclusion Ultrasound is still the main way to screen thyroid lesions at present,and it can effectively suggest information such as internal echo and marginal morphology of nodules.But MSCT has an advantage in suggesting internal calcification and gravel calcification of nodules,and it is beneficial to improve the screeningvalue of malignant nodules.