摘要
目的：探讨CT和超声的联合应用在良性甲状腺环状钙化诊断中的价值。方法：搜集经病理证实且CT或/和超声表现为环状钙化的75例86枚甲状腺资料，其中超声显示为环状钙化而CT呈非环状纳入CT不理想组，环状钙化的内部及后壁被声影覆盖纳入超声不理想组。以增强后钙化内或周围较平扫清晰或高强化作为CT诊断良性结节（BNS）的典型征象，以长弧形钙化作为超声判断BNS的典型征象，分别评价典型CT征象、超声征象和典型CT与超声征象联合在BNS中的敏感性和特异性。结果：86枚环状钙化中，CT不理想组9枚，典型CT征象在BNS和恶性结节（MNS）中分别为20%（1/5）和0%（0/4）（P＞0.05），理想组77枚，典型CT征象在BNS和MNS中分别为77.2%（44/57）和35%（7/20）（P＜0.05），典型CT征象对BNS的敏感性和特异性分别为77.2%和65.0%；超声不理想组17枚，BNS与MNS分别为70.6%（12/17）和29.4%（5/17）（P＞0.05），理想组69枚，典型超声征象在BNS和MNS中分别为77.6%（38/49）和10%（2/20）（P＜0.05），典型超声征象对BNS的敏感性和特异性分别为77.6%和90.0%；同时具备典型CT和超声征象在86枚环状钙化中的敏感性和特异性分别为39.3%和100%。结论：CT和超声在环状钙化的诊断中各有利弊，二者联合可以明显提高良性环状钙化诊断的特异性，减少不必要的手术创伤。
Abstract
Objective: To investigate the diagnostic value of CT combined with ultrasonography(US) for the diagnosis of benign annular calcification nodules in the thyroid gland. Methods: Eighty-six annular calcification nodules in 75 patients whom were detected by CT and?蛐or US were confirmed by pathology were included in this study. According to the collected imaging data, the nodules were divided into 2 groups: Group 1: CT was not diagnostic for benign thyroid nodules(BNS): in which US showed annular calcification, but showed no ring-like calcification on CT. A long curved-like calcification was the characteristic US sign for BNS. US is ideal for diagnosing BNS in this group. Group 2: US was not diagnostic for BNS, as the posterior wall of the annular calcification was covered by acoustic shadow, but on contrast CT when the interior content of the annular calcification or the rim of calcification had obvious enhancement or even more obviously enhanced was the CT characteristic sign for BNS. The sensitivity, specificity of the characteristic CT sign, the characteristic US sign, and combination of the two characteristic sign for BNS were evaluated. In this study, 61 nodules were BNS, and 25 nodules were malignant nodules(MNS). The imaging features of BNS and MNS were also compared. Results: In 86 annular calcification nodules, group 2 can see 77 nodules, and group 1 can see only 9. Group 1 can see 69 nodules and 17 in group 2. In group 2, the CT characteristic sign seen in BNS was 77.2%(44?蛐57), while in MNS was 35%(7?蛐20), P＜0.05. In group 1, the characteristic US sign seen in BNS was 77.6%(38?蛐49), while in MNS was 10%(2?蛐20), P＜0.05. The sensitivity and specificity of characteristic CT sign for BNS were 77.2% and 65.0% respectively. The sensitivity and specificity of US characteristic sign for BNS were 77.6% and 90.0% respectively. The sensitivity and specificity of the combined characteristic sign of CT and US for BNS were 39.3% and 100% respectively. Conclusion: Either CT alone or US alone has advantages and disadvantages in diagnosing the nature of annular calcification, but combined using CT and US can significantly improve the specificity of benign annular calcification in BNS vs MNS, and thus reduce unnecessary fine needle aspiration or even surgical operation.
关键词
甲状腺结节 /
超声检查 /
体层摄影术 /
X线计算机
Key words
Thyroid nodule /
Ultrasonography /
Tomography /
X-ray computed
黄雅元;包凌云;韩志江;舒艳艳;谷 莹;罗定存.
CT和超声的联合应用在良性甲状腺环状钙化诊断中的价值[J]. 中国临床医学影像杂志. 2014, 25(6): 385-389
HUANG Ya-yuan;BAO Ling-yun;HAN Zhi-jiang;SHU Yan-yan;GU Ying;LUO Ding-cun.
Diagnostic value of CT combined with ultrasonography for benign nodules in thyroid gland[J]. Journal of China Clinic Medical Imaging. 2014, 25(6): 385-389
中图分类号：
Ｒ581
Ｒ445.1
Ｒ814.42
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