摘要
目的探讨双源CT双能量扫描中碘图对甲状腺结节良恶性鉴别诊断的临床应用价值。方法测量36例(47个结节)甲状腺结节实性部分以及周围正常甲状腺组织的CT值与碘含量(碘值),采用受试者工作特性曲线(ROC曲线),选取最佳敏感度及特异性的临界值。并比较其与传统形态学诊断结果的一致性。结果恶性结节(20个)与良性结节(27个)CT值与碘值分别为22.9~52.1 HU[平均(30.2±0.5)HU]、-3.2~1.0 mg/ml(中位数-1.5 mg/ml),30.2~55.1 HU[平均(39.4±0.7)HU]、-0.5~1.8 mg/ml(中位数0.9 mg/ml);恶性结节与良性结节周围正常甲状腺组织CT值与碘值分别为47.4~85.6 HU[平均(66.8±1.3)HU]、1.1~3.2 mg/ml[平均(1.8±0.1)mg/ml],56.8~85.7 HU[平均(68.4±1.8)HU]、1.2~3.0 mg/ml[平均(1.7±0.1)mg/ml]。其中各组CT值与碘值具有相关性(r=0.755、0.678、0.813、0.774,P=0.000)。碘值临界值为0.15 mg/ml时,敏感度为81.50%,特异性为80.00%,且与传统形态学诊断结果具有较高一致性(Kappa值=0.742)。结论双源CT双能量扫描的碘图可测定甲状腺正常组织以及病变的含碘量,恶性结节的含碘量低于良性结节,可为甲状腺结节的良恶性鉴别提供更多的参考信息。
Objective To investigate the clinical application of iodine-enhanced image of dual-source computed tomography(DSCT) in distinguishing the benign and malignant thyroid nodules. Methods We calculated CT attenuation value and Iodine concentration of the thyroid nodules and adjacent normal thyroid tissues in 36 patients with total 47 thyroid nodules. And we utilized the receiver operating characteristic(ROC) curves by SPSS software to select the critical value of the optimum sensitivity and specificity, and compared its consistency with the diagnosis result of traditional morphology. Results The CT attenuation value and iodine concentration range of malignant nodules were 22.9-52.1 HU[average(30.2±0.5)HU]and-3.2-1.0 mg/ml(median-1.5 mg/ml), which was lower than those of benign nodules[30.2-55.1 HU average(39.4±0.7) HU and-0.5-1.8 mg/ml(median 0.9 mg/ml)](t=6.213, Z=-4.650, P=0.001, 0.000); The CT attenuation value and iodine concentration range of adjacent normal thyroid tissues of malignant nodules were 47.4~85.6 HU[average(66.8±1.3)HU] and 1.1-3.2mg/ml[average(1.8±0.1)mg/ml], with no significant difference with those of benign nodules[56.8-85.7 HU average(68.4±1.8)HU and 1.2-3.0 mg/ml [average(1.7±0.1)mg/ml)],(t=3.753, 0.932, P=0.225, 0.112). There was correlation between the CT attenuation value and iodine concentration range of each group(r=0.755, 0.678, 0.813, 0.774, P=0.000). When the critical value was 0.15 mg/ml, the sensitivity was 81.50% and the specificity was 80.00%, which were in high consistency with traditional morphological diagnosis result(Kappa=0.742). Conclusion Iodine-enhanced images of DSCT with dual energy scan could measure the Iodine concentration of the thyroid nodules and adjacent normal thyroid tissues.The iodine concentration range of malignant nodules is lower than those of benign nodules.And it may be an implemental tool for the differential diagnosis of benign and malignant thyroid nodules.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2015年第1期52-55,共4页
Cancer Research on Prevention and Treatment
关键词
甲状腺结节
双源CT
碘图
碘含量
Thyroid nodule
Dual-source CT
Iodine-enhanced image
Iodine concentration