双能量CT电子云密度和有效原子序数在甲状腺良恶性结节鉴别诊断中的价值
The value of dual-energy CT electron cloud density and effective atomic number in differential diagnosis of benign and malignant thyroid nodules
钟丽茹 1罗娜 1唐文杰1
作者信息
- 1. 中山大学附属第三医院放射科,广东 广州 510630
- 折叠
摘要
目的 探讨双能量CT电子云密度(Rho)及有效原子序数(Z)在甲状腺良恶性结节鉴别诊断中的价值.方法 回顾性分析2023年3月至12月在中山大学附属第三医院岭南医院经病理证实的68例甲状腺结节患者影像资料.68 例中,良性结节 31 例、恶性结节 37 例,均于术前 1 周内接受颈部CT平扫联合增强双能量扫描.利用后处理工作站重建动脉期、静脉期Rho及Z图并测量其数值,比较甲状腺良性与恶性结节的Rho值及Z值,分析差异有统计学意义的双能量参数,利用受试者操作特征(ROC)曲线分析其在甲状腺结节良性与恶性中的鉴别诊断效能.结果 动静脉期Z值和静脉期Rho值在甲状腺良性与恶性结节间比较差异均无统计学意义(P均>0.05),动脉期Rho值在甲状腺良性与恶性结节间比较差异有统计学意义(P<0.05),甲状腺恶性结节的动脉期Rho值高于良性结节,其ROC曲线下面积为 0.711(95%CI 0.586～0.836),灵敏度为 73.0%,特异度为 64.5%.当动脉期Rho值为 38.60 Hu时,其鉴别诊断效能最高.结论 双能量CT动脉期Rho值对甲状腺良恶性结节的鉴别诊断有一定价值.
Abstract
Objective To investigate the differential diagnostic value of dual-energy CT electron cloud density(Rho)and effective atomic number(Z)between benign and malignant thyroid nodules.Methods Imaging data of 68 patients with pathologically confirmed thyroid nodules at Lingnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University from March to December 2023 were retrospectively analyzed.Among the 68 cases,31 patients were diagnosed with benign thyroid nodules and 37 with malignant thyroid nodules.All patients underwent plain CT scan combined with enhanced dual-energy CT scan of the neck in the first week before surgery.The arterial-phase and venous-phase electron cloud density maps and effective atomic number maps were reconstructed in the post-processing workstation.Rho and Z values of benign and malignant thyroid nodules were compared by Mann-Whitney U test.Statistically significant dual-energy parameters were analyzed and their differential diagnostic efficiency in diagnosing benign and malignant thyroid nodules was calculated using the receiver operating characteristic(ROC)curve.Results Arterial-and venous-phase Z values and venous-phase Rho were not statistically significant between benign and malignant thyroid nodules(all P>0.05),whereas arterial-phase Rho value was statistically significant between benign and malignant thyroid nodules(P<0.05).The arterial-phase Rho of malignant thyroid nodules was higher than that of the benign thyroid nodules,with an area under the ROC curve(AUC)of 0.711(95%CI 0.586-0.836),a sensitivity of 73.0%,and a specificity of 64.5%.The differential diagnostic efficiency was the highest when the arterial-phase Rho was 38.6 Hu.Conclusion Dual-energy CT arterial-phase Rho mapping has certain value in the differential diagnosis of benign and malignant thyroid nodules.
关键词
双能量CT/电子云密度图/有效原子序数/甲状腺结节Key words
Dual-energy CT/Electron cloud density/Effective atomic number/Thyroid nodule引用本文复制引用
基金项目
广东省自然科学基金面上项目(2022A1515010369)
出版年
2024
国家科技期刊平台
NSTL
万方数据