Value of the combination of sonography with CT in the diagnosis and differential diagnosis of thyroid follicular lesions

SHU Yan-yan; BAO Ling-yun; HAN Zhi-jiang; CHEN Wen-hui; LEI Zhi-kai; DING Jin-wang

Journal of China Clinic Medical Imaging ›› 2013, Vol. 24 ›› Issue (8) : 543-547.

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Value of the combination of sonography with CT in the diagnosis and differential diagnosis of thyroid follicular lesions

SHU Yan-yan1, BAO Ling-yun2, HAN Zhi-jiang2, CHEN Wen-hui2, LEI Zhi-kai2, DING Jin-wang2

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Abstract

Objective: To assess the value of the combination of sonography with CT in the diagnosis and differential diagnosis of thyroid follicular lesions. Methods: CT and sonography findings of 135 lesions in 122 patients with thyroid follicular lesions were retrospectively analyzed, all of the patients had pathologic diagnosis. One hundred and twenty-two leisions in 109 patients with adenomatoid noduler goiter(ANG), 13 lesions in 13 patients with follicular carcinoma(FC) were included. A round or oval shape lesion which possesses internal homogeneous echo and a clear boundary acoustic halo was considered as characteristic follicular adenomatoid nodule(FAN) in sonography, and a lesion which possesses higher enhancement than thyroid was considered as characteristic FAN on CT. The sensibility and specificity of the characteristic sonographic sign, the computed tomgrphic sign, and the combiniation of sonogrphic and computed tomgrphic sign were analyzed respectively in the diagnosis of FAN. The characteristic sonographic sign, the computed tomgrphic sign, and ring calcification in FAN and FC were analyzed. Results: Among the 135 lesions in the group, 1 FAN and 2 FC were excluded because of acoustic attenuation of ring calification, the sensibility and specificity of the characteristic sonographic sign was 72.7%(88/121) and 54.5%(6/11) respectively; the sensibility and specificity of the characteristic computed tomgrphic sign was 68.9%(84/122) and 84.6%(11/13) respectively; and of the combiniation of sonogrphic and computed tomgrphic sign was 91.0%(111/122) and 61.5%(8/13). There was no statistical difference in the characteristic sonographic sign between FAN and FC(P＞0.05), but had statistical difference in the characteristic computed tomgrphic sign and ring calcification(P＜0.05). Conclusions: CT has higher specificity than sonography in the diagnosis of FAN, and the combination of sonography with CT can improve the specificity in the diagnosis of FAN; ring calcification and lower enhancement than the normal surrounding thyroid are helpful for the diagnosis of FC.

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Thyroid diseases / Tomography / X-ray computed / Ultrasonography

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SHU Yan-yan;BAO Ling-yun;HAN Zhi-jiang;CHEN Wen-hui;LEI Zhi-kai;DING Jin-wang. Value of the combination of sonography with CT in the diagnosis and differential diagnosis of thyroid follicular lesions[J]. Journal of China Clinic Medical Imaging. 2013, 24(8): 543-547