To Evaluate The Clinical Value Of CT In The Diagnosis Of Benign And Malignant Thyroid Nodules

Objective:To evaluate the diagnostic ability of dual-source dual-energy CT for benign and malignant thyroid nodules,and its clinical application value.Methods:A total of sixty-nine patients with single thyroid nodules were selected and they were all treated from January 2016 to June 2017,the cases were confirmed by surgery and pathology,data integrity,There were 21 cases of papillary carcinoma,1 case of medullary carcinoma,1 case of follicular carcinoma,35 cases of nodular goiter,11 cases of thyroid adenoma.The scanning was performed using the SIEMENS dual source computed tomography(SOMATOM Definition Flash)before the operation.Firstly,the boundary,and calcification of thyroid nodules were analyzed under the condition of plain computed tomography scanning.Then,under the condition of enhanced computed tomography scanning,the enhancement and enhancement of thyroid nodule,the lymph nodes were analyzed.Finally,in the condition of dual-source computed tomography,the treatment of iodine overlay map and the statistical analysis of iodine content.Retrospective analysis of 69 patients clinical data and computed tomography imaging data.Computed tomography imaging were independently reviewed by two experienced radiologists at PACS,when the diagnosis is inconsistent,the consistency result is discussed.Computed tomography image observation indicators were the boundary,calcification,enhanced features,lymph node enlargement,and thyroid solid iodine value.The pathological results were compared with that of the preoperative computed tomography image.The SPSS20.0 statistical software for statistical analysis,count data by chi-square test to P<0.05 for the difference was statistically significant.The iodine content of the metering data is the non-normal distribution,and the median is used to describe the statistics.Wilcoxon rank and test were adopted,and the threshold value of the optimal sensitivity and specificity was selected.Results:1.In the plain computed tomography scan,of benign and malignant thyroid nodules,there is no statistical difference in terms of boundary is clear,P value of 0.059.Thyroid nodule calcification and there was no statistically significant difference the diagnosis of benign and malignant thyroid nodule,P value of 0.107.Pathological changes of the form and the diagnosis of benign and malignant thyroid nodule calcification differences statistically significant(P<0.05).2.In the computed tomography enhanced scan,There was no significant difference between thyroid nodules and benign and malignant thyroid nodules,P value of 0.855.Lesions in the way of enhancement and the diagnosis of benign and malignant thyroid nodule differences statistically significant(P<0.05).Thyroid nodule presence of enlarged lymph nodes and the diagnosis of benign and malignant thyroid nodule differences statistically significant(P<0.05).Neck VI area increases with the diagnosis of benign and malignant thyroid nodule lymph node differences statistically significant(P<0.05).3.In the dual-source computed tomography iodine overlay map.The iodine value of the benign nodules of thyroid nodules is(-0.6-1.9)mg/ml,and the median is 0.9mg/ml;The iodine content of thyroid malignant nodules was(-2.8-1.1)mg/ml,the median was-1.0mg/ml,and the iodine content of benign nodules was significantly higher than that of malignant nodules,and the difference was statistically significant(Z=-3.339,P=0.001).The receiver-operating characteristic curve method using SPSS software,selecting optimum sensitivity and specific threshold,when the AUC value =0.837,the diagnosis accuracy is higher,the best point of the critical value of 0.55 mg/ml,sensitivity to 85%,the specific degree of 65%.When 0.55 mg/ml or less,7 cases of benign nodule,15 cases of malignant nodule.There were 39 benign nodules and 8 malignant nodules when greater than 0.55mg/ml.Conclusions:Dual-source dual-energy CT can play a role in thyroid benign and malignant judgment.The iodine content of the double energy iodine can provide a quantitative index for the clinical judgment of benign and malignant thyroid nodules.