双能CT对甲状腺结节诊断效能与病理学类型的相关性研究

Research on the Correlation between Diagnostic Efficacy and Pathological Type of Dualenergy CT in Thyroid Nodules

目的:探讨双能CT对甲状腺结节诊断价值、病理组织学类型的相关性,旨在提高甲状腺癌临床诊断准确性。方法:选取2018年1月至2020年10月我院头颈外科诊治的甲状腺结节患者224例,其中甲状腺癌组148例设为观察组,甲状腺良性结节76例设为对照组,分析术前CT表现并与术后病理学结果对照。结果:224例甲状腺结节患者中,观察组甲状腺癌148例、对照组良性结节76例,102例结节形态不规则,104例结节出现"半岛状"瘤结节,106例结节出现"强化残圈"征,89例出现"沙粒样"钙化,84例恶性结节侵犯周围组织器官;动、静脉期甲状腺良性结节标准化碘浓度比率、能谱曲线斜率均高于甲状腺癌组,组间差异显著。结论:双能CT定量分析结合CT征象对甲状腺结节鉴别有一定特征性,不同病理类型与碘图、能谱曲线关系密切,可作出正确的术前诊断,并为临床诊治提供影像学依据。

Objective:We intended to explore the correlation between diagnostic efficacy and histopathological types when dual-energy CT was applied in thyroid nodules,aiming to improve the accuracy of clinical diagnosis of thyroid cancer.Methods:We selected 224 patients with thyroid nodules diagnosed and treated by head and neck surgery in our hospital from January 2018 to October 2020.148 cases with thyroid cancer formed observation group while 76 cases with benign thyroid nodules formed contrast group,then the preoperative CT manifestations were analyzed and compared with postoperative pathological results.Results:Among the 224 patients with thyroid nodules(148 cases with thyroid cancer formed the observation group while 76 cases with benign nodules formed the contrast group),102 cases showed irregular nodules,104 cases showed"peninsular"nodules,106 nodules showed"enhanced remnant"signs,89 cases showed"sand-lik"calcification and 84 cases with malignant nodules showed tumor invasion on surrounding tissues and organs.The ratio of standard iodine concentration and the slope of energy spectrum curve of benign thyroid nodules in arteriovenous stage were higher than those in malignant nodule group.We found significant differences between the two groups.Conclusion:The quantitative analysis of dual energy CT combined with CT signs hold certain characteristics for thyroid cancer discriminations.Different pathological types are closely related with iodine map and energy spectrum curve,which can lead to correct preoperative diagnosis and provide imaging basis for clinical diagnosis and treatment.