The value of coarse calcification in thyroid nodules on CT in the diagnosis and differential diagnosis between benign and malignant lesions
SHU Yan-yan1, CHEN Wen-hui2, HAN Zhi-jiang2, DING Jin-wang2
1. Department of Radiology, the First People’s Hospital of Hangzhou, Xiaoshan Area, Hangzhou 311200, China;2. The First People’s Hospital of Hangzhou, Hangzhou 310006, China
摘要目的：总结甲状腺结节粗钙化的CT特点，评价粗钙化在良恶性结节诊断和鉴别诊断中的价值。方法：回顾分析经手术病理证实的175例217枚粗钙化结节，依据钙化周围有无软组织肿块将其分为单纯粗钙化（SCC）和非单纯粗钙化（non-SCC），再依据钙化的形态将non-SCC分为规则粗钙化和不规则粗钙化。观察SCC、规则粗钙化、不规则粗钙化及增强后钙化周围较平扫清晰在良恶性结节中的分布，并统计SCC对良性结节、增强后钙化周围较平扫清晰对non-SCC的良性结节及不规则粗钙化对non-SCC的恶性结节诊断的敏感性、特异性、阳性预测值和准确度。结果：217枚粗钙化中，169枚为良性结节，48枚为恶性结节。SCC多见于良性结节中（P<0.05），增强后钙化周围较平扫清晰多见于non-SCC的良性结节中（P<0.05），而不规则粗钙化多见于non-SCC的恶性结节中（P<0.05）。SCC对良性结节、增强后钙化周围较平扫清晰对non-SCC的良性结节及不规则粗钙化对non-SCC的恶性结节诊断的敏感性、特异性、阳性预测值和准确度分别为29% vs 60.8% vs 57.1%、87.5% vs 71.4% vs 71.7%、89.1% vs 85.9% vs 41.4%和41.9% vs 63.6% vs 67.9%。结论：SCC有助于良性结节的诊断，增强后钙化周围较平扫清晰倾向于non-SCC的良性结节的诊断，而不规则粗钙化则提示non-SCC的恶性结节的诊断。
Abstract：Objective: To summarize the computed tomgraphic characteristic of thyroid nodule with coarse calcification and assess the value of coarse calcification in the diagnosis and differential diagnosis between benign nodules and malignant nodules. Methods: CT findings of 217 nodules with coarse calcifications in 175 patients were retrospectively analysed. All of the patients had pathological diagnosis. Coarse calcifications were divided into simple coarse calcifications(SCC) and non-simple coarse calcifications(non-SCC) according to an associated mass around them, and non-SCC were subdivided into regular coarse calcifications and irregular coarse calcifications according to calcification patterns. Observing the distribution of SCC, regular coarse calcifications, irregular coarse calcifications and clearer borderline around coarse calcifications on enhanced CT than plain CT, and analyse the sensitivity, specificity, positive predicive value and accuracy of SCC for benign nodules, clearer borderline around coarse calcifications on enhanced CT than plain CT for benign nodules of non-SCC and irregular coarse calcifications for malignant nodules of non-SCC. Results: Among 217 coarse calcifications, 169 coarse calcifications were benign nodules, and 48 coarse calcifications were malignant nodules. SCC was more common in benign nodules(P<0.05), clearer borderline around coarse calcifications on enhanced CT than on plain CT was more common in benign nodules of non-SCC(P<0.05), and irregular coarse calcifications was more common in malignant nodules of non-SCC(P<0.05). The sensitivity, specificity, positive predicive value and accuracy of SCC for benign nodules, clearer borderline around coarse calcifications on enhanced CT than on plain CT for benign nodules of non-SCC and irregular coarse calcifications for malignant nodules of non-SCC were 29% vs 60.8% vs 57.1%, 87.5% vs 71.4% vs 71.7%, 89.1% vs 85.9% vs 41.4% and 41.9% vs 63.6% vs 67.9% respectively. Conclusions: SCC are helpful for the diagnosis of benign nodules, clearer borderline around coarse calcifications on enhanced CT than on plain CT indicate the diagnosis of benign nodules of non-SCC, and irregular coarse calcifications for malignant nodules of non-SCC.
舒艳艳;陈文辉;韩志江;丁金旺. 甲状腺结节粗钙化的CT诊断和鉴别诊断[J]. , 2013, 24(12期): 849-853.
SHU Yan-yan;CHEN Wen-hui;HAN Zhi-jiang;DING Jin-wang. The value of coarse calcification in thyroid nodules on CT in the diagnosis and differential diagnosis between benign and malignant lesions. , 2013, 24(12期): 849-853.
2013, Vol. 24 
