目的 探讨超声造影与多层螺旋 CT在甲状腺良恶性结节鉴别诊断中的价值 及其对甲状腺腺瘤的影像表现特点。方 法 选取46例甲状腺腺瘤患者和28例甲状 腺乳头状癌患者为研究对象，均经病理检 查确诊且同时接受术前超声造影和多层 螺旋CT检查。对比两种检查方式对良恶 性结节的鉴别诊断价值差异，分析其影像 学表现特点。结果 超声造影和多层螺旋 CT对良恶性甲状腺结鉴别诊断的敏感性对 比无统计学意义(P>0.05)；多层螺旋CT对 良恶性甲状腺结鉴别诊断的特异性和准确 性显著低于超声造影(P<0.05)。46例甲状 腺腺瘤患者多层螺旋CT平扫多数可见均匀 低密度灶，且边界清晰，钙化征和囊性灶 偏少，仅少数边界欠清，且密度不均匀； 40例患者增强扫描见病灶实性部分明显强 化，且强化密度显著高于病灶周围正常组 织。46例受试者中44例超声造影表现为高 增强(95.7%)，部分可见环状增强带；2例 (4.3%)表现为等增强，均呈均匀增强特 点。结论 超声造影和多层螺旋CT均在甲 状腺腺瘤中具有特异性影像学表现，临床 可将其联合作为鉴别诊断良恶性甲状腺结 节的有效手段，以此降低误诊风险，改善 患者预后水平。

Objective To investigate the value of contrast-enhanced ultrasonography and multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodules and the imaging findings of thyroid adenomas. Methods Forty-six cases of patients with thyroid adenomas and 28 cases of patients with papillary thyroid carcinomas were selected as study subjects. All patients were confirmed by pathological examination and underwent preoperative contrast-enhanced ultrasonography and multi-slice spiral CT examination. The value of the two methods in the differential diagnosis of benign and malignant nodules was compared. The imaging findings were analyzed. Results There was no significant difference in sensitivity between contrast-enhanced ultrasonography and multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodes (P>0.05). The specificity and accuracy of multi-slice spiral CT in differential diagnosis of benign and malignant thyroid nodules were significantly lower than those of contrast enhanced ultrasonography (P<0.05). CT plain scan of 46 patients with thyroid adenomas mainly showed homogeneous and low-density lesions, with clear boundaries, few calcification signs and cystic lesions. Only a few boundaries were unclear, and the density was inhomogeneous. The enhanced scan of 40 patients showed there was enhancement in solid part of the lesions, and the density was significantly higher than that of the normal tissues around the lesions. Among the 46 subjects, the findings of contrast-enhanced ultrasonography in 44 patients showed high enhancement (95.7%), with presence of partial annular enhancement bands, and 2 cases (4.3%) with homogeneous enhancement, showing homogeneous enhancement. Conclusion Both of contrast-enhanced ultrasonography and multi-slice spiral CT have specific imaging findings in thyroid adenomas. In clinic, the combination of the two can be used as an effective means for differential diagnosis of benign and malignant thyroid nodules to reduce the risk of misdiagnosis and improve the prognosis.