能谱CT对桥本甲状腺炎背景下良恶性结节的诊断价值

The Value of Energy Spectrum CT in The Diagnosis of Benign and Malignant Nodules in The Background of Hashimoto’s Thyroiditis

目的通过能谱CT对桥本甲状腺炎(HT)背景下结节进行分析,得出HT背景下良恶性结节的各能谱CT参数大小,从而探究能谱CT对HT伴良恶性结节的鉴别诊断价值。方法搜集HT伴结节的患者46例,共53枚结节,根据病理结果分为良性(32枚)、恶性(21枚)两组。通过能谱CT平扫加增强扫描,得出平扫、动脉、静脉三期结节的碘浓度(IC),分别计算动、静脉期结节的标准化碘浓度(NIC)。利用单能量成像得出结节的能谱曲线斜率。并绘制受试者工作特征曲线(ROC)比较各参数诊断效能。结果恶性结节平扫IC、能谱曲线斜率均较良性结节低,均有统计学差异(P<0.05),敏感度分别为81.0%、85.7%,特异度分别为68.7%、62.5%。恶性结节动脉期IC、NIC、能谱曲线斜率均低于良性结节,均有统计学差异(P<0.05),敏感度分别为66.7%、85.7%、61.9%,特异度分别为88.4%、68.7%、87.5%。静脉期良恶性结节的IC、NIC、能谱曲线斜率均无统计学差异。结论能谱CT对HT背景下良恶性结节具有较好的鉴别诊断价值。

Objective To analyze the nodules on the background of Hashimoto's thyroiditis(HT)by energy spectrum CT,and obtain the energy spectrum CT parameters of benign and malignant nodules on a background of HT,so as to explore the effect of energy spectrum CT on the differential diagnosis value of HT with benign and malignant nodules.Methods A total of 46 patients with HT with nodules,a total of 53 nodules,were divided into two groups:benign(32)and malignant(21)based on the pathological results.Through energy spectrum CT plain scan and enhanced scan,the iodine concentration(IC)of plain scan,arterial and venous nodules were obtained,and the normalized iodine concentration(NIC)of arterial and venous nodules were calculated respectively.Use single-energy imaging to obtain the slope of the energy spectrum curve(λHU)of the nodule.And draw a receiver operating characteristic curve(ROC)to compare the diagnostic efficacy of each parameter.Results The IC andλHU of malignant nodules were lower than those of benign nodules,with statistical differences(P<0.05).The sensitivity was 81.0%and 85.7%,and the specificity was 68.7%and 62.5%,respectively.The IC,NIC,andλHU of the arterial phase of malignant nodules were lower than those of benign nodules,and there were statistical differences(P<0.05).The sensitivity was 66.7%,85.7%,and 61.9%,and the specificity was 88.4%and 68.7%,respectively.,87.5%.There was no significant difference in IC,NIC,andλHU of benign and malignant nodules in the venous phase.Conclusion Energy spectrum CT has a good value in the differential diagnosis of benign and malignant nodules under the background of HT.