假包膜征在甲状腺微小乳头状癌CT增强诊断中的价值

The value of Pseudo-Capsule Sign in CT Diagnosis of Papillary Thyroid Microcarcinoma

目的:探讨假包膜征在增强CT诊断甲状腺微小乳头状癌(PTMC)中的价值。方法:收集经组织病理学证实为PTMC的73例患者(共83枚结节)的CT和病理资料。分别观察CT增强早期、晚期PTMC是否存在假包膜征,并与病理结果对照,行Kappa一致性检验,比较增强早期、晚期图像对假包膜征的显示效果。根据CT上假包膜的范围,分类为包膜型和亚包膜型。结果:在CT增强早期有42枚显示假包膜征,在增强晚期有7枚显示假包膜征,与病理对照的Kappa值分别为0.71(P<0.05)和0.064(P>0.05)。根据CT增强早期、晚期的图像,判定83枚PTMC中有43枚(51.81%)存在假包膜征,其中包膜型19枚,亚包膜型24枚。结论:假包膜征在PTMC的CT诊断中具有较高的诊断价值。增强CT早期对假包膜征的显示效果优于增强晚期。对假包膜征进行分类,可更好地识别PTMC的假包膜征。

Purpose:To investigate the value of pseudo-capsule sign in the diagnosis of papillary thyroid microcarcinoma(PTMC)with enhanced CT scan.Methods:CT images and pathological data of 83 PTMC confirmed by histopathology results were collected.The pseudo-capsule sign of PTMC was observed by contrast-enhanced CT in the early and late stage,and compared with pathological results.Kappa consistency test was performed to compare the display effect of two groups of images on pseudo-capsule sign.According to the scope of pseudo-capsule on CT,it was classified into capsule type and subcapsular type.Results:In the early stage of contrast-enhanced CT,42 cases showed pseudo-capsule sign,and 7 showed pseudo-capsule sign in late enhanced CT.The kappa values of contrastenhanced CT in early stage and late stage were 0.71(P<0.05)and 0.064(P>0.05).Among the 83 PTMCs according to the early stage and late stage of enhanced CT,43(51.81%)had pseudo-capsule sign,including 19 with capsule type and 24 with subcapular type.Conclusions:Pseudo-capsule sign has a high diagnostic value in the diagnosis of PTMC.The display effect of enhanced CT in the early stage is better than that in the late stage.The classification of pseudo-capsule sign can better identify the pseudo-capsule sign of PTMC.