| 莫威行,韩志江,周健,张卧.高强化在甲状腺CT双期增强扫描良、恶性结节性质判断中的价值[J].浙江中西医结合杂志,2016,26(8): |
| 高强化在甲状腺CT双期增强扫描良、恶性结节性质判断中的价值 |
| Value of Obvious Enhancement in Judging Benign and Malignant Node Property of Thyroid with CT Double-Phase Enhancing Scanning |
| 投稿时间：2016-02-26 修订日期：2016-03-29 |
| DOI： |
| 中文关键词: 甲状腺结节 癌 X线计算机 体层摄影术 |
| 英文关键词:Thyroid node Cancer X-ray computer Tomography |
| 基金项目:杭州市重大科技创新专项项目(No.20131813A08)；杭州市卫生科技计划项目(No.2014A02) |
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| 中文摘要: |
| 目的 探讨高强化在甲状腺CT双期增强扫描良、恶性结节性质判断中的价值。方法 回顾分析经手术及病理证实的686例1019枚甲状腺结节的CT平扫和双期增强扫描(注药后25s和50s)资料,其中良性结节701枚,恶性结节318枚,分别统计25s、50s、25s 50s和25s或50s扫描序列中,高强化在良、恶性结节中的分布,计算四组扫描序列中高强化对良性结节诊断的敏感性和特异性。结果 25s、50s、25s 50s和25s或50s四组扫描序列中,高强化在良、恶性结节中发生率分别为9.3%(65/701)和1.9%(6/318)(χ2=18.409,P=0.000)、10.4%(73/701)和1.6%(5/318)(χ2=24.192,P=0.000)、7.6%(53/701)和1.3%(4/318)(χ2=16.456,P=0.000)、12.1%(85/701)和2.2%(7/318)(χ2=26.233,P=0.000),高强化对良性结节诊断的敏感性和特异性在各组中分别为9.3%和98.1%、10.4%和98.4%、7.6%和98.7%、12.1%和97.8%。结论 在四组扫描序列中,尽管敏感性均存在一定不足,但高度的特异性提示双期增强扫描中的高强化有助于良性结节的诊断,其中单期增强50s优于25s扫描,25s或50s在保持高度特异性的基础上具有最高的敏感性,为减少不必要的手术创伤提供了重要的依据。 |
| 英文摘要: |
| ABSTRACT Objective To discuss the value of obvious enhancement in judgment on benign and malignant node property of thyroid with CT double-phase enhancing scanning. Method To retrospectively analyze information of 1019 thyroid nodes of 686 cases verified by operation and pathology which are scanned by CT plain scanning and double-phase enhancing scanning (25s and 50s after administration), including 701 benign nodes and 318 malignant nodes, and to implement statistics of distribution of obvious enhancement in benign and malignant nodes in sequence of 25s, 50s, 25s 50s and 25s or 50s scanning respectively, and compute sensitivity and specificity of obvious enhancement on benign node diagnosis in four groups of scanning in sequence. Result In four groups of scanning sequence of 25s, 50s, 25s 50s and 25s or 50s, the occurrence rate of obvious enhancement in benign and malignant nodes is 9.3% (65/701) and 1.9 % (6/318) (χ2=18.409, P=0.000), 10.4%（73/701）and 1.6%（5/318）(χ2=24.192, P=0.000), 7.6%（53/701） and 1.3%（4/318）(χ2=16.456, P=0.000), 12.1%（85/701）and 2.2%（7/318）(χ2=26.233, P=0.000) respectively, and the sensitivity and specificity of obvious enhancement on benign node diagnosis in four groups is 9.3% and 98.1%, 10.4% and 98.4% , 7.6% and 98.7%, 12.1% and 97.8% respectively. Conclusion In four groups of scanning sequence, the excellent specificity shows that the obvious enhancement in double-phase enhancing scanning contributes to diagnosis on benign node although the sensitivity is insufficient. The single-phase enhancing scanning of 50s is superior to that of 25s, and that of 25s or 50s has the highest sensitivity on the basis of keeping high specificity, which provides important basis for decreasing unnecessary operation wound. |
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