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| The value of CT intensive pattern in the differential diagnosis of papillary thyroid microcarcinoma and micronodular goiter |
| HAN Jing, ZHANG Jing, HAN Zhi-jiang, LAI Xu-feng |
| Hangzhou First People’s Hospital, Hangzhou 310006, China |
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Abstract Objective: To investigate the value of CT enhancement pattern in differential diagnosis of papillary thyroid microcarcinoma(PTMC) and micronodular goiter(MNG). Methods: The CT data of 267 cases of thyroid nodules with a diameter of 0.5~1.0 cm confirmed by operation and pathology were retrospectively analyzed. Of them, there were 143 cases of 160 PTMC and 124 of 167 MNG. The ratios of CT values(plane scan/enhanced scan, PS/ES) and the difference(ΔCT value) between benign and malignant nodules were calculated respectively, the PS/ES and ΔCT values of benign and malignant nodules were statistically analyzed by t test, and best thresholds of PS/ES and ΔCT to identify PTMC and MNG were determined by ROC curve. Results: Among 160 PTMC and 167 MNG, the PS/ES(t=10.35, df=319.346, P<0.001) and ΔCT values (t=-10.242, df= 322.712, P<0.001) were statistically significant. The area under the ROC curve was 0.799 for PS/ES. When PS/ES was 0.525, the maximum Youden index was 0.520, the sensitivity and specificity were 83.1%(133/160) and 68.9%(115/167), respectively. The ΔCT value under the ROC curve was 0.808. When the ΔCT value was 51.5 HU, the Youden index was the largest (0.514), the sensitivity and specificity were 82.5%(132/160) and 68.9%(115/167), respectively. Meanwhile, the sensitivity and specificity for PTMC with PS/ES≤0.525 and ΔCT value>51.5 HU were 78.1%(125/160) and 78.4%(131/167), respectively. Conclusion: Both PS/ES≤0.525 and ΔCT value>51.5 HU are important parameters in diagnosis of PTMC. The combination of the two can further improve the diagnostic specificity and reduce the misdiagnosis.
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Received: 28 November 2017
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