CT鉴别诊断甲状腺乳头状癌与结节性甲状腺肿的临床价值分析

Clinical Value of CT in Differential Diagnosis of Papillary Thyroid Carcinoma and Nodular Goiter

目的:分析CT鉴别诊断甲状腺乳头状癌与结节性甲状腺肿的临床价值。方法:回顾性分析2019年1月—2022年12月临沂市沂水县人民医院收治的76例甲状腺结节高危风险患者的临床资料,病理结果显示,甲状腺乳头癌34例,结节性甲状腺肿42例。两组患者均接受CT检查,统计CT检查在甲状腺乳头状癌与结节性甲状腺肿中的诊断效能,分析两种疾病的CT影像学表现,明确CT检查在两种疾病中的鉴别诊断价值。结果:CT检查诊断甲状腺乳头状癌与结节性甲状腺肿的灵敏度为95.24%,特异度为97.06%,准确度为96.05%;甲状腺乳头癌结节体积、腺体峡部厚度大于结节性甲状腺肿,左叶腺体体积、右叶腺体体积小于结节性甲状腺肿,差异有统计学意义(P<0.001);甲状腺乳头癌单发结节、结节规则、甲状腺侵及被膜、钙化、晕圈占比高于结节性甲状腺肿,边界清晰、分界清楚、内部均匀占比低于结节性甲状腺肿,差异有统计学意义(P<0.05)。结论:CT鉴别诊断甲状腺乳头状癌与结节性甲状腺肿的临床价值较高,可为临床两种疾病的早期诊疗提供依据。

Objective:To analyze the clinical value of CT in differential diagnosis of papillary thyroid carcinoma and nodular goiter.Methods:Clinical data of seventy-six patients with high risk of thyroid nodules treated in Linyi Yishui County People's Hospital from January 2019 to December 2022 were retrospectively analyzed.The pathological results showed that there were thirty-four cases of papillary carcinoma and forty-two cases of nodular goiter.CT examination was performed in both groups to evaluate the diagnostic efficacy of CT in papillary thyroid carcinoma and nodular goiter.The CT imaging findings of the two diseases were analyzed to clarify the value of CT in the differential diagnosis of the two diseases.Results:The sensitivity,specificity and accuracy of CT in the diagnosis of papillary thyroid carcinoma and nodular goiter were 95.24%,97.06%and 96.05%;the nodular volume and isthmus thickness of papillary carcinoma were higher than that of nodular goiter,and the volume of left lobe gland and right lobe gland were lower than that of nodular goiter,the difference was statistically significant(P<0.001);the proportion of single nodules,nodular rules,thyroid invasion and capsule,calcification and halos in papillary thyroid carcinoma was higher than that in nodular goiter,and the proportion of clear boundary,clear boundary and internal uniform was lower than that in nodular goiter,the difference was statistically significant(P<0.05).Conclusion:CT is of high clinical value in the differential diagnosis of papillary thyroid carcinoma and nodular goiter,which can provide basis for the early diagnosis and treatment of the two diseases.