目的 探讨能谱CT参数在诊断鉴 别甲状腺良恶性病变中的应用价值。方法 收集2017年2月-2018年2月96例因颈部肿 块而接受颈部能谱CT检查的患者，根据手 术病理结果分为良性组与恶性组；比较两 组病灶、正常甲状腺组织、颈总动脉碘含 量(IC)及水含量(WC)、动脉标准化碘含量 (NICA)、正常甲状腺标准碘含量(NICT)、 能谱曲线斜率(γHU)，并采用受试者工 作曲线(ROC)分析相关能谱参数对甲状腺 病变性质的诊断效能。结果 与良性组相 比，恶性组IC病灶、NICT、γHU均明显增大 (P<0.05)；而两组其他能谱参数比较差异 无统计学意义(P>0.05)。以病理诊断结 果为金标准，绘制IC病灶、NICT、γHU诊断 甲状腺病变性质的ROC曲线，结果显示， 三者曲线下面积分别为0.712、0.698、 0.702，截断值分别为3.15mg/ml、0.52、 3.70，敏感度、特异度、准确度分别为 73.02%、71.05%、72.27%和49.21%、 81.58%、61.39%及66.67%、76.32%、 70.30%。结论 能谱CT多种参数对诊断鉴 别甲状腺良恶性病变性质有重要作用。

Objective To investigate the application value of energy spectrum CT parameters in differential diagnosis of benign and malignant thyroid lesions. Methods Ninety-six patients who underwent neck energy spectrum CT for cervical lumps during the period from February 2017 to February 2018 were divided into the benign group and the malignant group according to the surgical and pathological results. The lesions, normal thyroid tissues, common carotid artery iodine content (IC) and water content (WC), arterial standard iodine content (NICA), normal thyroid standard iodine content (NICT) and energy spectrum slope of curve (γHU) were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of relevant energy spectrum parameters for the nature of thyroid lesions. Results Compared with the benign group, IC lesions, NICT and γHU were significantly larger in the malignant group (P<0.05), but there was no significant difference in the other parameters between the two groups (P>0.05). With the results of pathological diagnosis as the golden standard, the ROC curves for the diagnosis of thyroid lesions by IC lesion, NICT and γHU were drawn. The results showed that the areas under the curves were 0.712, 0.698 and 0.702, respectively, and the cut-off values were 3.15 mg/ml, 0.52 and 3.70, respectively. The sensitivities, specificities and accuracy rates were 73.02%, 71.05% and 72.27%, 49.21%, 81.58% and 61.39%, and 66.67%, 76.32% and 70.30%, respectively. Conclusion The various parameters of energy spectrum CT play an important role in differential diagnosis of benign and malignant thyroid lesions.