目的 探讨螺旋CT在甲状腺良恶 性结节鉴别诊断中的应用价值。方法 选 取2016年2月-2018年3月本院收治的86例 甲状腺结节疾病患者为研究对象，均行螺 旋CT检查，以病理结果为金标准，评估螺 旋CT在甲状腺良恶性结节鉴别诊断中的 应用价值。结果 多层螺旋CT诊断甲状腺 良恶性结节的灵敏度、特异度、准确度 各为88.13%、81.48%、86.05%，Kappa值 为0.682；良性结节组形态规则、边缘清 晰、钙化条片状占比较恶性结节组明显高 (P＜0.05)，两组病灶部位、有无囊变占 比相较差异不显著(P＞0.05)，甲状腺良 性结节组均匀强化占比明显高于恶性结节 组(P＜0.05)，而残圈样强化、半岛样强 化占比明显低于恶性结节(P＜0.05)。结 论 螺旋CT对甲状腺良恶性结节鉴别诊断 效能较高，临床上可依据甲状腺结节疾病 患者螺旋CT影像学特征和强化特征差异对 其良恶性进行鉴别。

Objective To investigate the value of spiral CT in differential diagnosis of benign and malignant thyroid nodules. Methods A total of 86 patients with thyroid nodular diseases who were admitted to the hospital during the period from February 2016 to February 2018 were selected as subjects. All patients underwent spiral CT examination. With pathological results as the golden standard, the value of spiral CT in differential diagnosis of benign and malignant thyroid nodules was evaluated. Results The sensitivity, specificity and accuracy of multi-slice spiral CT in the diagnosis of benign and malignant thyroid nodules were 88.13%, 81.48% and 86.05%, and the Kappa value was 0.682, respectively. The proportions of regular shape, clear edges and calcified strips in the benign nodule group were significantly higher than those in the malignant nodule group (P<0.05), but there was no significant difference between the two groups in the location of lesions or the proportion of cystic change (P>0.05). The proportion of homogeneous enhancement in the benign nodule group was significantly higher than that in the malignant nodule group (P<0.05), while the proportions of residual ring-like enhancement and peninsulalike enhancement were significantly lower than those in the malignant nodule group (P<0.05). Conclusion The diagnostic efficiency of spiral CT is high for benign and malignant thyroid nodules. The spiral CT imaging features and enhancement features can be used to distinguish benign and malignant thyroid nodules.