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目的探讨甲状腺部分囊性乳头状癌(Partially cystic papillary carcinoma,PCPC)与部分囊性结节性甲状腺肿(partially cystic nodular goiter,PCNG)的CT鉴别诊断。方法回顾分析经组织学证实的8例8枚PCPC和26例27枚PCNG的CT资料,观察结节内微钙化、乳头状结构、结节形态、壁结节数目及形态在PCPC和PCNG中的分布,统计微钙化、乳头状结构、结节形态不规则、单发壁结节对PCPC诊断的敏感性、特异性、阳性预测值和准确度。结果微钙化、乳头状结构、结节形态不规则及单发壁结节均好发于PCPC中(P<0.05),其敏感性分别为75%、75%、75%、100%,特异性分别为100%、70.4%、95.6%、88.9%,阳性预测值分别为100%、42.9%、75.0%、72.3%,准确度分别为94.3%、71.4%、88.6%、91.4%。3枚弧形钙化均见于PCNG中。结论结节内微钙化、乳头状结构、结节形态不规则、单发壁结节等对PCPC的诊断具有重要价值,而形态规则、多发壁结节/环状或半环状壁结节、弧状钙化有助于PCNG的诊断。
Objective To investigate the differential diagnosis of CT in partial thymic papillary carcinoma (PCPC) and partially cystic nodular goiter (PCNG). Methods The CT data of 8 PCPCs in 8 cases and 27 PCNGs in 26 cases confirmed by histology were retrospectively analyzed. The numbers of microcalcifications, papillary structures, the number of nodules, the number of wall nodules and their morphology in PCPC and PCNG were observed Distribution, statistical microcalcifications, papillary structures, nodular irregularities, sensitivity, specificity, positive predictive value and accuracy of single wall nodules for PCPC diagnosis. Results Micro-calcifications, papillary structures, irregular nodules and single wall nodules all occurred in PCPC (P <0.05), with sensitivity of 75%, 75%, 75%, 100%, specificity The positive predictive values were 100%, 42.9%, 75.0% and 72.3%, respectively, with the accuracy of 94.3%, 71.4%, 88.6% and 91.4% respectively, which were 100%, 70.4%, 95.6% and 88.9% respectively. Three arc calcifications were found in PCNG. Conclusion The nodules with microcalcifications, papillary structures, irregular nodules, single wall nodules, etc. are of great value in the diagnosis of PCPC. However, morphological features, multiple nodules / annular or semi-annular wall nodules, Arc calcification contributes to the diagnosis of PCNG.