目的 探讨64层螺旋CT对甲状腺 良恶性结节的扫描影像特点及鉴别价值。 方法 回顾性分析确诊50例甲状腺结节样 病变患者临床及64层螺旋CT影像资料，观 察比较不同性质(良性与恶性)甲状腺结节 影像表现(直径、数目、形态、边界、钙 化等)，同时以病理结果为标准，分析64 层螺旋CT对甲状腺结节性质的诊断敏感 性、特异度及准确度。结果 病理证实恶 性结节20例，良性结节30例；甲状腺恶 性结节单发、不规则、边界模糊、砂粒 样钙化、邻近结构侵犯分别占80.00%、 70.00%、75.00%、55.00%、55.00%，均 显著高于良性结节的33.33%、26.67%、 26.67%、20.00%、0.00%，差异有统计 学意义(P＜0.05)；甲状腺恶良性结节直 径、囊变、密度大小比较差异无统计学 意义(P＞0.05)。MSCT对甲状腺恶性结 节诊断敏感度、特异度、准确度分别为 85.00%、90.00%、88.00%。结论 64层螺 旋CT检查通过结节数目、形态、边界、邻 近结构侵犯与否等征象显示有利于甲状腺 结节良恶性鉴别。

Objective To investigate the 64 slice spiral CT imaging features of benign and malignant thyroid nodules and its value in in the differential diagnosis. Methods The clinical and 64 slice spiral CT imaging data of 50 patients with thyroid nodular lesions were analyzed retrospectively. The imaging findings (diameter, number, shape, boundary, calcification, etc.) were observed and compared between different properties (benign and malignant) of thyroid nodules. Meanwhile, based on the pathological results, the sensitivity, specificity and accuracy of 64 slice spiral CT in the diagnosis of thyroid nodules were analyzed. Results 20 cases of malignant nodules and 30 cases of benign nodules were confirmed pathologically. Malignant thyroid nodules which were solitary, irregular, with fuzzy boundaries, with sand like calcification and adjacent structure involvement accounted for 80.00%, 70.00%, 75.00%, 55.00% and 55.00% respectively which were significantly higher than those of the benign nodules (33.33%, 26.67%, 26.67%, 20.00%, 0.00%) (P<0.05). There were no significant differences in diameter, cystic degeneration and density of benign thyroid nodules (P>0.05). The sensitivity, specificity and accuracy of MSCT in the diagnosis of thyroid malignant nodules were 85.00%, 90.00% and 88.00%, respectively. Conclusion 64 slice spiral CT examination can display the number, shape, boundary and adjacent structure invasion or not, which is beneficial to distinguish benign and malignant thyroid nodules.