CT平扫对甲状腺单纯粗钙化结节良、恶性的预测价值

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摘要目的：探讨CT平扫对甲状腺单纯粗钙化结节（SCCN）良、恶性的预测价值。方法：回顾分析经手术病理证实的92例92枚SCCN的CT资料，其中57枚为良性结节，35枚为恶性结节。对比骨窗（W 1 000~2 000 HU，L 300~350 HU）SCCN是否具有分隔，以及软组织窗（W 300~350 HU，L 35~40 HU）周围是否具有伪影。统计分隔及伪影征象在良、恶性结节中的分布，并采用χ2检验进行统计学分析。结果：92枚SCCN中，有分隔、无伪影和二者联合在良性结节和恶性结节中分别占50.9%（29/57）和80.0%（28/35）（χ2=7.803，P=0.005）、26.3%（15/57）和71.4%（25/35）（χ2=17.958，P=0.000）、3.5%（2/57）和57.1%（20/35）（χ2=34.284，P=0.000），其诊断恶性结节的敏感度和特异度分别为80.0%（28/35）和49.1%（28/57）、71.4%（25/35）和73.7% （42/57）、57.1%（20/35）和96.5%（55/57），无分隔和有伪影联合在良性结节和恶性结节中分别占38.6%（22/57）和5.7%（2/35）（χ2=12.162，P=0.000），其诊断良性结节的敏感度和特异度分别为38.6%（22/57）和94.3%（33/35）。结论：CT平扫对SCCN良、恶性的预测具有重要的价值，有分隔和无伪影有助于恶性结节的诊断，无分隔和有伪影则提示良性结节的诊断，二者联合可以明显提高诊断特异度。

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	胡斌1
	赖旭峰2
	韩志江2
	雷志锴2

关键词 ：甲状腺肿, 结节性, 甲状腺肿瘤, 体层摄影术, 螺旋计算机

Abstract：Objective: To investigate the predictive value of plain CT scan in simple coarse calcific thyroid nodules(SCCN). Methods: The CT data of 92 SCCN in 92 cases confirmed by operation and pathology were retrospectively analyzed, including 57 benign nodules and 35 malignant nodules. The bone window(W 1 000~2 000 HU, L 300~350 HU) and soft tissue window(W 300~350 HU, L 35~40 HU) were used to identify whether SCCN had septa and peripheral artifacts, respectively. The number of benign and malignant nodules which had septa and artifacts were counted, followed by χ2 test for statistical analysis. Results: In 92 SCCN, the proportions of septa, no artifacts and their combination in the benign and malignant nodules were 50.9%(29/57) and 80.0%(28/35)(χ2=7.803, P=0.005), 26.3%(15/57) and 71.4%(25/35)(χ2=17.958, P=0.000), 3.5%(2/57) and 57.1%(20/35)(χ2=34.284, P=0.000), respectively. Their sensitivity and specificity of diagnosing malignant nodules were 80.0%(28/35) and 49.1%(28/57), 71.4%(25/35) and 73.7%(42/57), 57.1%(20/35) and 96.5%(55/57), respectively. The combination of no septa and artifacts in benign and malignant nodules accounted for 38.6%(22/57) and 5.7%(2/35)(χ2=12.162, P=0.000), respectively. Their sensitivity and specificity of diagnosing benign nodules were 38.6%(22/57) and 94.3%(33/35). Conclusion: CT scan for predicting benign and malignant SCCN was of significant value. Septa and no artifacts contributed to the diagnosis of malignant nodules, while no septa and artifacts suggested the diagnosis of benign nodules. Their combination could significantly improve the diagnostic specificity.

Key words： Goiter, nodular Thyroid neoplasms Tomography, spiral computed

收稿日期: 2016-04-01

PACS:	Ｒ581
	Ｒ736.1
	R814.42

基金资助:2013杭州市重大科技创新专项项目（20131813A08）；2015年省医药卫生一般研究计划（2015KYB293）

通讯作者: 韩志江

作者简介: 胡斌（1985-），男，江西抚州人，医师。E-mail：422915234@qq.com

引用本文:

胡斌1，赖旭峰2，韩志江2，雷志锴2. CT平扫对甲状腺单纯粗钙化结节良、恶性的预测价值[J]. 中国临床医学影像杂志, 2016, 27(11): 774-777.
HU Bin1, LAI Xu-feng2, HAN Zhi-jiang2, LEI Zhi-kai2. Predictive value of plain CT scan in thyroid benign and malignant simple coarse calcific thyroid nodules. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(11): 774-777.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I11/774

[1]Lu Z, Mu Y, Zhu H, et al. Clinical value of using ultrasound to assess calcification patterns in thyroid nodules[J]. World J Surg, 2011, 35(1): 122-127.
[2]Shi C, Li S, Shi T, et al. Correlation between thyroid nodule calcification morphology on ultrasound and thyroid carcinoma[J]. J Int Med Res, 2012, 40(1): 350-357.
[3]Park M, Shin JH, Han BK, et al. Sonography of thyroid nodules with peripheral calcifications[J]. J Clin Ultrasound, 2009, 37(6): 324-328.
[4]Kim BM, Kim MJ, Kim EK, et al. Sonographic differentiation of thyroid nodules with eggshell calcifications[J]. J Ultrasound Med, 2008, 27(10): 1425-1430.
[5]Yoon DY, Lee JW, Chang SK, et al. Peripheral calcification in thyroid nodules: ultrasonographic features and prediction of malignancy[J]. J Ultrasound Med, 2007, 26(10): 1349-1355.
[6]韩志江，陈文辉，项晶晶，等. CT环状钙化鉴别甲状腺结节良恶性的价值[J]. 中华放射学杂志，2014，48（4）：275-278.
[7]Lee J, Lee SY, Cha SH, et al. Fine-needle aspiration of thyroid nodules with macrocalcification[J]. Thyroid, 2013, 23(9): 1106-1112.
[8]Kim BK, Choi YS, Kwon HJ, et al. Relationship between patterns of calcification in thyroid nodules and histopathologic findings[J]. Endocr J, 2013, 60(2): 155-160.
[9]Park YJ, Kim JA, Son EJ, et al. Thyroid nodules with macrocalcification: sonographic findings predictive of malignancy[J]. Yonsei Med J, 2014, 55(2): 339-344.
[10]Zhu D, Chen W, Xiang J, et al. Diagnostic value of CT artifacts for solitary coarse calcifications in thyroid nodules[J]. Int J Clin Exp Med, 2015, 8(8): 5800-5805.
[11]舒艳艳，陈文辉，韩志江，等. 甲状腺结节粗钙化的CT诊断和鉴别诊断[J]. 中国临床医学影像杂志，2013，24（12）：849-853.
[12]Wu CW, Dionigi G, Lee KW, et al. Calcifications in thyroid nodules identified on preoperative computed tomography: patterns and clinical significance[J]. Surgery, 2012, 151(3): 464-470.
[13]刘伟，杨军，张毅，等. 钙化征在CT鉴别诊断甲状腺良、恶性病变中的价值[J]. 中华放射学杂志，2010，44（2）：147-151.
[14]Kim HG, Moon HJ, Kwak JY, et al. Diagnostic accuracy of the ultrasonographic features for subcentimeter thyroid nodules suggested by the revised American Thyroid Association guidelines[J]. Thyroid, 2013, 23(12): 1583-1589.
[15]Nakashima Y, Nakano T. Optimizing contrast agents with respect to reducing beam hardening in nonmedical X-ray computed tomography experiments[J]. J Xray Sci Technol, 2014, 22(1): 91-103.
[16]Moon WJ, Kwag HJ, Na DG. Are there any specific ultrasound findings of nodular hyperplasia(“leave me alone” lesion) to differentiate it from follicular adenoma?[J]. Acta Radiol, 2009, 50(4): 383-388.
[17]Hoang JK, Branstetter BT, Gafton AR, et al. Imaging of thyroid carcinoma with CT and MRI: Approaches to common scenarios[J]. Cancer Imaging, 2013, 13(12): 128-139.