CT对微小甲状腺乳头状癌与微小结节性甲状腺肿的鉴别诊断价值

CT value in differential diagnosis of papillary thyroid microcarcinoma and micronodular goiter

目的:探讨CT对微小甲状腺乳头状癌(PTMC)与微小结节性甲状腺肿(MNG)的鉴别诊断价值。方法:回顾性选取经病理证实的45例(48个结节)PTMC患者(PTMC组)和63例(72个结节)MNG患者(MNG组),比较2组CT征象,分析CT对PTMC的诊断效能。结果:CT诊断甲状腺良恶性结节的准确率为92.50%;PTMC组结节细颗粒状钙化、增强扫描结节轮廓模糊、边缘中断征比例均高于MNG组(均P<0.05);PTMC组动脉期及静脉期CT值较平扫的增加幅度均高于MNG组(均P<0.05);动脉期及静脉期CT值联合诊断PTMC的AUC为0.865,诊断效能最高(P<0.05)。结论:CT征象在PTMC与MNG鉴别诊断方面具有较高的价值,综合分析甲状腺良恶性结节的各种CT征象,有助于提高PTMC的检出率。

Objective:To explore the value of CT in the differential diagnosis of papillary thyroid microcarcinoma(PTMC)and micronodular goiter(MNG).Methods:Clinical data of 45 PTMC patients(48 nodules,PTMC group)and 63 MNG patients(72 nodules,MNG group)confirmed by pathology were retrospectively analyzed.The CT signs of the two groups were compared,and the diagnostic value of CT signs on PTMC was analyzed.Results:The accuracy rate of CT in the diagnosis of benign and malignant thyroid nodules was 92.50%.The proportions of nodules with fine granular calcification,blurred contour of nodules after enhancement and edge disruption in PTMC group were significantly higher than those in MNG group(all P<0.05).The increase in CT values in arterial and venous phases compared with plain scan in the PTMC group were higher than those in the MNG group(both P<0.05).The AUC of the combined CT values in arterial and venous phases in the diagnosis of PTMC was 0.865,indicating the highest diagnostic efficiency(P<0.05).Conclusions:CT signs are of high value in the differential diagnosis of PTMC and MNG.Comprehensive analysis of CT signs of benign and malignant thyroid nodules will help to improve the detection rate of PTMC.