CAJ | 학술논문

目的探讨高强化CT征象在甲状腺良恶性结节诊断和鉴别诊断中的价值.方法收集经组织学证实的1676例2926枚甲状腺结节的CT资料,其中包括良性结节2174枚,恶性结节752枚,将结节的强化程度分为高强化和等低强化,统计高强化CT征象在良恶性结节中的分布,观察高强化CT征象对良性结节及其中的腺瘤样结节诊断的敏感性、特异性、阳性及阴性预测值和准确度.结果高强化CT征象在良性结节较恶性结节中更常见,所占比例分别为10.3％和0.7％(x2=70.259,P＜0.05),其敏感性、特异性、阳性及阴性预测值和准确度分别为9.8％、99.5％、98.2％、27.6％和32.8％;高强化CT征象在腺瘤样结节较非腺瘤样良性结节中更常见,所占比例分别为67.4％和6.1％(x2=525.025,P＜0.05),其敏感性、特异性、阳性及阴性预测值和准确度分别为67.4％、93.9％、41.6％、97.8％和92.3％.结论高强化CT征象在甲状腺良恶性结节及腺瘤样结节与非腺瘤样良性结节鉴别诊断中具有重要价值,高强化征象有助于良性结节及腺瘤样结节的诊断.
목적 탐토고강화CT정상재갑상선량악성결절진단화감별진단중적개치.방법 수집경조직학증실적1676례2926매갑상선결절적CT자료,기중포괄량성결절2174매,악성결절752매,장결절적강화정도분위고강화화등저강화,통계고강화CT정상재량악성결절중적분포,관찰고강화CT정상대량성결절급기중적선류양결절진단적민감성、특이성、양성급음성예측치화준학도.결과 고강화CT정상재량성결절교악성결절중경상견,소점비례분별위10.3％화0.7％(x2=70.259,P＜0.05),기민감성、특이성、양성급음성예측치화준학도분별위9.8％、99.5％、98.2％、27.6％화32.8％;고강화CT정상재선류양결절교비선류양량성결절중경상견,소점비례분별위67.4％화6.1％(x2=525.025,P＜0.05),기민감성、특이성、양성급음성예측치화준학도분별위67.4％、93.9％、41.6％、97.8％화92.3％.결론 고강화CT정상재갑상선량악성결절급선류양결절여비선류양량성결절감별진단중구유중요개치,고강화정상유조우량성결절급선류양결절적진단.
Objective To assess the value of CT hyperenhancement sign in diagnosis and differential diagnosis of benign and malignant thyroid nodules.Methods CT findings of 2926 nodules in 1676 patients were retrospectively analyzed,among which 2174 nodules were benign and 752 nodules were malignant.All the patients had pathological diagnosis.The degrees of enhancement were divided into hyperenhancement and iso/hypoenhancement.The distribution of hyperenhancement in benign and malignant nodules were summarized.The sensitivity,specificity,positive and negative predictive value and accuracy of hyperenhancement for benign nodules and adenomatoid nodules were observed.Results Hyperenhancement was more common in benign nodules than in malignant nodules (10.3％ vs 0.7％,x2 =70.259,P ＜ 0.05),and its sensitivity,specificity,positive and negative predictive value and accuracy was 9.8％,99.5％,98.2％,27.6％ and 32.8％,respectively.Hyperenhancement was more common in adenomatoid nodules than in nonadenomatoid benign nodules (67.4％ vs 6.1％,x2 =525.025,P ＜ 0.05),and its sensitivity,specificity,positive and negative predictive value and accuracy was 67.4％,93.9％,41.6％,97.8％ and 92.3％,respectively.Conclusion Hyperenhancement sign is an important sign which can effectively differentiate benign nodules from malignant nodules,and adenomatoid nodules from nonadenomatoid benign nodules,and it is helpful for diagnosis of benign nodules and adenomatoid nodules.