超声联合CT在甲状腺癌术前诊断中的应用观察

Application of Ultrasound Combined with CT in Preoperative Diagnosis of Thyroid Cancer

目的观察超声联合电子计算机断层扫描(CT)在甲状腺癌术前诊断中的应用价值。方法研究对象为2016年1月至2019年1月在我院接受手术治疗的200例甲状腺癌患者,回顾性分析其超声及CT影像学资料,记录淋巴结转移情况,并以手术病理作为对照,明确超声、CT及超声联合CT对甲状腺癌淋巴结转移的临床价值。结果与病理对照,超声诊断甲状腺癌淋巴结转移的敏感度为84.95%、特异度为90.80%、准确率为87.50%、阳性预测值为92.30%、阴性预测值为82.29%,Kappa值为0.748;CT诊断甲状腺癌淋巴结转移的敏感度为90.26%、特异度为90.80%、准确率为90.50%、阳性预测值为92.72%、阴性预测值为87.77%、Kappa值为0.807;超声联合CT诊断甲状腺癌淋巴结转移的灵敏度为93.80%、特异度为93.10%、准确率为93.50%、阳性预测值为94.64%、阴性预测值为92.04%、Kappa值为0.867;单一超声或CT诊断时,CT敏感度、准确率、阳性预测值、阴性预测值均略高于单一超声诊断,但差异无统计学意义(P>0.05);超声联合CT诊断时敏感度、特异度、准确率、阳性预测值、阴性预测值均高于单一超声或CT诊断,但差异无统计学意义(P>0.05)。结论无论是超声或是CT用于甲状腺癌术前淋巴结转移诊断均能发挥一定诊断价值,联合应用或能进一步提升诊断效能。

Objective To observe the application value of ultrasound combined with computed tomography(CT)in preoperative diagnosis of thyroid cancer.Methods The study o bjects were 200 patients with thyroid cancer who underwent surgery in the hospital from January 2016 to January 2019.Their ultrasound and CT imaging data were retrospectively analyzed.The lymph node metastasis was recorded.Ta king surgical pathology as controls,the clinical value of ultrasound,CT,and their combination in lymph node metastasis of thyroid cancer was determined.Results Compared with pathology,sensitivity,specificity,accuracy,positive predictive valu e,negative predictive valu e,and Ka ppa value of ult rasound for the diagnosis of lymph node metastasis of thyroid cancer were 84.95%,90.80%,87.50%,92.30%,82.29%,and 0.748,respectively.The above 6 indexes of CT were 90.26%,90.80%,90.50%,92.72%,87.77%,and 0.807,respectively.The above 6 indexes of ultrasound combined with CT were 93.80%.93.10%,93.50%,94.64%,92.04%,a nd 0.867,respectively.The sensitivity,accuracy,positive predictive value and negative predictive value of CT were slightly higher than those of ultrasound(P>0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ultrasound combined with CT were higher than ultrasound or CT(P>0.05).Conclusion Both ultrasound and CT can play diagnostic value in preoperative lymph node metastasis of thyroid cancer.The combined application may further improve diagnostic efficiency.