高频超声联合CT增强对甲状腺癌的诊断价值

Significance of high frequency ultrasound plus CT enhancement in diagnosis of thyroid carcinoma

目的:探讨高频超声联合CT增强扫描对甲状腺癌的诊断价值。方法:回顾性分析2019年1月~2020年1月弋矶山医院甲乳外科可疑甲状腺癌患者(94例)的资料,共142个瘤体,在排除相关干扰因素的情况下,以CT能显示病灶为基础,根据瘤体大小分为两组,A组(瘤体长径≤5 mm)52个,B组(瘤体长径>5 mm)90个,且所有患者术前均行甲状腺高频超声及CT增强检查,以病理诊断为金标准,分析甲状腺癌的超声诊断特点及CT增强前后的变化,分别比较整体及A、B两组高频超声及CT增强诊断甲状腺癌的准确度。结果:两种检查方法整体准确度分别为75.4%(高频超声)、62.0%(CT增强),差异有统计学意义(P=0.015)。A组两种检查方法的准确度分别为61.5%(高频超声)、26.9%(CT增强),差异有统计学意义(P=0.000)。B组两种检查方法的准确度分别为83.3%(高频超声)、82.2%(CT增强),差异无统计学意义(P=0.844)。高频超声对甲状腺癌伴颈部淋巴结转移的检出率为26.9%,CT增强的检出率为69.2%,两种检查方法的检出率差异有统计学意义(P<0.05)。结论:对于较小长径(≤5 mm)的甲状腺癌及其颈部淋巴结的转移情况,应使用高频超声联合CT增强的检查方法。

Objective:To investigate the diagnostic value of high frequency ultrasound with enhanced CT in thyroid carcinoma.Methods:The imaging data were reviewed in 94 patients with suspected thyroid cancer(a total of 142 tumors)diagnosed in the Department of Thyroid&Breast Surgery of our hospital between January of 2019 and 2020.Tumors were divided into group A(≤5 mm,n=52 tumors)and group B(>5 mm,n=90 tumors)according the tumor length based on related interference factors being excluded and lesions shown on CT.All patients underwent examination by high frequency ultrasound and enhanced CT.Pathological findings were used as gold standard for analysis of the diagnostic characteristics of thyroid cancer by ultrasound and the changes before and after enhanced CT as well as comparison of the accuracy of two imaging modalities in the diagnosis of thyroid cancer.Results:The overall accuracy was 75.4%for high frequency ultrasound and 62.0%for CT enhancement.The difference was significant(P=0.015).The accuracy by high frequency ultrasound and enhanced CT was 61.5%and 26.9%,respectively in group A(P=0.000),yet was 83.3%and 82.2%,respectively in group B,without significant difference(P=0.844).The detection rate for thyroid cancer with cervical lymph node metastasis was 26.9%by high-frequency ultrasound and 69.2%by enhanced CT.There was a significant difference between the two methods(P<0.05).Conclusion:Combined high-frequency ultrasound with enhanced CT is recommended for diagnosis of thyroid cancer with small length diameter(≤5 mm)and metastasis to cervical lymph nodes.