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目的探讨双源CT碘图与能谱曲线技术在甲状腺结节鉴别诊断中的应用价值。方法回顾性分析58例经病理证实并行双能量模式(DECT)增强扫描的甲状腺结节患者的影像资料,利用“Liver VNC”“Monoenergytic”软件处理得到碘图与能谱曲线,对甲状腺结节碘图和能谱曲线进行比较研究。结果良性结节的碘含量明显低于正常甲状腺组织高于恶性结节,甲状腺良恶性结节内实性成分之间的碘含量差异有统计学意义(P<0.05);良性组所有结节单能谱成像病变实性成分呈下降型曲线,与正常甲状腺组织能谱走行一致,恶性组呈上升型曲线,少部分表现下降型曲线。良性组曲线斜率在三个期相均大于恶性组,在平扫和动脉期,两组间的曲线斜率两两比较差异均有统计学意义(P<0.05);双能CT检查的灵敏度为88.5%,特异性为92.9%,准确率为96.2%。结论碘图定量分析和能谱曲线技术可提高甲状腺结节定性诊断的准确率,为甲状腺疾病临床诊疗提供新的影像学检查方法。
Objective To investigate the value of dual-source CT iodine mapping and energy spectrum curve in the differential diagnosis of thyroid nodules. Methods We retrospectively analyzed the imaging data of 58 thyroid nodules with pathologically confirmed concurrent dual-energy mode (DECT) enhancement scan. The iodine and energy spectra were obtained by using “Liver VNC ” and “Monoenergytic” software. Thyroid nodules iodine and energy spectrum curve were compared. Results The iodine content of benign nodules was significantly lower than that of normal thyroid tissue (P <0.05), and the content of iodine in the benign and malignant thyroid nodules was statistically significant (P <0.05). All benign nodules The real component of spectrum imaging lesion showed a descending curve, which was consistent with that of the normal thyroid tissue. The malignant group showed an ascending curve and the descending curve. The curve slope of benign group was greater than that of malignant group in three phases, and the slope of curve between the two groups was statistically significant (P <0.05) in plain scan and arterial phase. The sensitivity of dual-energy CT was 88.5 %, The specificity was 92.9%, the accuracy rate was 96.2%. Conclusion Quantitative analysis of iodine and energy spectrum curve technique can improve the accuracy of qualitative diagnosis of thyroid nodules and provide a new imaging method for the clinical diagnosis and treatment of thyroid diseases.