目的 探讨甲状腺良、恶性病变 的CT诊断鉴别。方法 收集我院48例甲状 腺病变患者影像学资料，根据良、恶性病 变分为良性组与恶性组，并与术后病理 诊断比较，评估CT对甲状腺良恶性病变 的诊断效能，并分析两组CT成像特点。结 果 手术病理显示良性病变27例，恶性病 变21例；CT检查显示良性病变26例，恶性 病变22例，示CT诊断甲状腺良恶性病变的 灵敏度为92.6％，特异度96.8％，阳性预 测值96.2％，阴性预测值93.8％，准确率 94.8％。其中良性甲状腺病变以多发结节 为主，其结节边缘形态清晰、密度均匀、 甲状腺包膜完整，多无沙砾样钙化，且多 无淋巴结肿大，但良恶性病变结节的密度 及囊变程度差异不大。结论 CT可用于甲 状腺良、恶性病变检查，具有较高的诊断 应用价值。

Objective To investigate the diagnosis and differential diagnosis of benign and malignant thyroid lesions with CT signs. Methods The imaging data of 48 patients with thyroid diseases were collected. The patients were divided into benign group and malignant group according to benign and malignant lesions. Compared with postoperative pathological diagnosis, the effectiveness of CT in the diagnosis of benign and malignant thyroid diseases was evaluated, and CT imaging characteristics of the two groups were analyzed. Results Operation and pathology showed 27 cases of benign lesions and 21 cases of malignant lesions while CT examination showed 26 cases of benign lesions and 22 cases of malignant lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in the diagnosis of benign and malignant thyroid lesions were 92.6%, 96.8%, 96.2%, 93.8% and 94.8%, respectively. The majority of benign thyroid lesions were multiple nodules. The nodules were with clear edges and shape, even density and intact thyroid capsule and without grit-like calcification. There was no lymph node enlargement in most patients. However, there was no significant difference in the density and degree of cystic degeneration between benign and malignant nodules. Conclusion CT can be used in the examination of benign and malignant thyroid lesions. It is of high diagnostic value and is worthy of clinical application.