CT 对甲状腺良恶性钙化结节的鉴别诊断价值

Differential diagnostic value of CT in benign and malignant calcified nodules of thyroid

摘要:

目的 探讨CT 对甲状腺良恶性钙化结节鉴别的诊断价值。方法 回顾性分析2013 年1 月— 2016 年12 月安徽医科大学第二附属医院经手术切除病理证实的204 例甲状腺钙化结节的CT 及临床资料， 根据钙化形态将其分为细颗粒和粗颗粒钙化；根据钙化在结节中的位置，分为中央和边缘；统计细颗粒钙 化、中央及两者联合在良恶性结节中的分布，并进行统计学分析。结果 良恶性结节的钙化类型、钙化位置 比较，差异有统计学意义（P <0.05）；良恶性结节是否细钙化+ 中央位置、粗钙化+ 边缘位置比较，差异有统 计学意义（P <0.05）。以细颗粒钙化和中央位置为标准诊断甲状腺恶性结节的敏感性为81.3%（95%CI ：67.0， 95.5），特异性为89.3%（95%CI ：80.9，97.6）；以粗颗粒钙化和边缘位置为标准诊断甲状腺良性结节的敏感性 为80.4%（95%CI ：69.6，91.1），特异性为90.6%（95%CI ：79.9，101.3）。结论 甲状腺结节中出现细颗粒状钙 化及位于中央为CT 诊断甲状腺恶性结节的重要征象，甲状腺结节中出现粗颗粒状钙化及位于边缘为CT 诊 断甲状腺良性结节的重要征象。

Abstract:

Objective To evaluate the differential diagnostic value of CT in benign and malignant thyroid nodules. Methods The CT and clinical data of 204 cases of thyroid calcification nodules confirmed by pathology from January 2013 to December 2016 were retrospectively analyzed. According to the calcification morphology, 204 cases were divided into fine granular calcification group and coarse granular calcification group. According to the location of calcification in the nodule, 204 cases were divided into central group and marginal group. Calcification morphology, calcification location and their combination in benign and malignant nodules were statistically analyzed by χ2 test. Results The calcification morphology and calcification location of benign and malignant nodules were statistically significant (P < 0.05), and their combination was also statistically significant (P < 0.05). The sensitivity of thyroid malignant nodules diagnosed by fine granular calcification and central location as standard was [81.3% (26/32), 95% CI: 67.0, 95.5%], and specificity of those was [89.3% (50/56), 95% CI: 80.9, 97.6%]; the sensitivity of diagnosis of benign thyroid nodules diagnosed by coarse granular calcification and margin location as standard was [80.4% (45/56), 95% CI: 69.6, 91.1%], and specificity of those was [90.6% (29/32), 95% CI: 79.9,101.3%]. Conclusions Calcifications in the thyroid nodule fine-grained and centrally located are important signs of CT diagnosis of malignant thyroid nodules, while calcifications in the thyroid nodule coarse-grained and located at the edge of the thyroid are important signs of benign thyroid nodules.