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| The value of CT features and the combination in diagnosing papillary thyroid carcinoma |
| ZHU Miao-ping1, ZHOU Xiu-yan2, HAN Zhi-jiang3 |
| 1. Department of Radiology, the Women’s Hospital of Hangzhou, Hangzhou 310006, China; 2. CT Room,Liaoning Suizhong County Hospital, Huludao Liaoning 125200, China; 3. Department of Radiology, the First People’sHospital of Hangzhou, Hangzhou Center of Diagnosis and Treatment of Thyroid Disease, Hangzhou 310006, China |
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Abstract Objective: To investigate the value of CT features and the combination in diagnosing papillary thyroid carcinoma(PTC). Methods: We retrospectively identified the CT features of 192 lesions in 184 cases with diameter larger than 1.0 cm, including the morphology, the bite cookie sign, enhancement features and microcalcifications, and compared with 222 lesions in 170 cases of nodular goiters with diameter larger than 1.0 cm. Then we evaluated the sensitivity, specificity and accuracy with different CT features pattern. Results: Twelve lesions in 12 cases of PTC and 6 lesions in 5 cases of NG were excluded because of complete calcification, influence from Hashimoto thyroiditis, ambiguous morphology or enhancement feature. Thus, 180 lesions in 172 cases of PTC and 216 lesions in 165 cases of NG were included in this study. Morphology, bite cookie sign, enhancement features and microcalcifications showed statistically significant difference between papillary thyroid carcinomas and nodular goiters(P<0.05 for all). The bite cookie sign showed the highest sensitivity, specificity and accuracy of 84%, 94% and 90%, respectively, compared with the other three CT features. Combining two signs together, irregular shape and bite cookie sign showed the highest sensitivity, specificity and accuracy of 71%, 100% and 86%, respectively. Combining three signs together, irregular shape, bite cookie sign, enhancement features or microcalcifications showed the highest sensitivity, specificity and accuracy of 23%, 100% and 65%. Combining four signs together showed a sensitivity, specificity and accuracy of 19%, 100% and 63%. Conclusion: Single CT feature shows a high sensitivity and low specificity relatively in diagnosing PTC, while the combination of different CT signs significantly improves the specificity, reducing the incidence of misdiagnosis.
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Received: 18 June 2014
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Corresponding Authors:
HAN Zhi-jiang
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2014, Vol. 25 
