目的 探讨多排螺旋CT在甲状腺 癌临床诊断和鉴别诊断中的应用价值。 方法 选取西安交通大学医学院附属西 安市中心医院收治的55例疑似甲状腺癌 患者为研究对象,均接受多排螺旋CT检 查。以外科手术或病理检查结果为依 据，评估多排螺旋CT在甲状腺癌临床诊 断中的敏感性、特异性和准确性，记录 其在甲状腺癌鉴别诊断中的符合率。结 果 病理或手术检查结果显示55例疑似 甲状腺癌患者中甲状腺癌32例(58.2%)， 良性病变23例(41.8%)；多排螺旋CT扫描 定性诊断结果显示真阳性28例，真阴性 20例，假阳性3例，假阴性的4例；多排 螺旋CT对甲状腺癌定性诊断的准确性、 特异性、敏感性分别为87.3%(48/55)、 87.0%(20/23)和87.5%(28/32)；对乳头 状癌、滤泡状癌、髓样癌及未分化癌 等甲状腺癌的鉴别诊断准确率分别为 94.7%(18/19)、71.4%(5/7)、66.7%(2/3) 和100.0%(3/3)。结论 临床可将多排螺旋 CT作为诊断及鉴别诊断甲状腺癌的有效辅 助手段，以提高诊疗筛查针对性，节省诊 疗时间、改善患者预后水平。

Objective To investigate the application value of multi-slice spiral CT(MSCT) in clinical diagnosis and differential diagnosis of thyroid cancer. Methods 55 patients with suspected thyroid cancer who were admitted into the Central Hospital of Xi'an City Affiliated to Medical College of Xi'an Jiaotong University were selected as the study object. All the patients underwent MSCT examination. The results of surgical or pathological examination were taken as the basis to evaluate the sensitivity, specificity and accuracy of MSCT in diagnosis of thyroid cancer. The coincidence rate in the differential diagnosis of thyroid cancer was recorded. Results The results of pathological or surgical examination showed that in 55 patients with suspected thyroid cancer, there were 32 cases (58.2%) with thyroid cancer and 23 cases (41.8%) with benign lesions; The qualitative diagnostic results of MSCT scan showed that 28 cases were true positive, 20 cases true negative, 3 cases false positive and 4 cases false negative; The accuracy, specificity and sensitivity of CT in the qualitative diagnosis of thyroid cancer were 87.3% (48/55), 87.0% (20/23) and 87.5% (28/32), respectively; The accurate rates in differential diagnosis of thyroid cancer such as papillary carcinoma, follicular carcinoma, medullary carcinoma and undifferentiated carcinoma were 94.7% (18/19), 71.4% (5/7), 66.7% (2/3) and 100.0% (3/3). Conclusion In clinic, MSCT can be used as an effective supplementary method in differential diagnosis of thyroid cancer to improve the pertinence of diagnosis and treatment, so as to improve the time of diagnosis and treatment and improve the prognosis of patients.