| Objective: To explore the diagnostic value of double-low CT perfusion technique in thyroid nodules,the correlation between perfusion parameter values and pathological microvessel counts,and provide a basis for in vivo imaging evaluation of angiogenesis in thyroid nodules.Methods: From March 1st,2018 to November 1st,2018,patients with thyroid nodules were treated in the Department of Breast Surgery,People’s Hospital of Yichang City Center.A total of 43 patients,including 7 males and 36 female patients,were collected.Five patients with multiple nodules,38 patients with nodules,a total of 54 thyroid nodules.All patients used a German 64-row dual-source spiral low-dose CT scan.After the scan is complete,the data is measured using the image post-processing software in the workstation.Select the region of interest with the largest level of nodule area,select 3 ROI areas for each case,and the computer will automatically calculate the perfusion parameter blood flow(BF),Patlak blood volume(P-BV),permeability.(premeability,Per)and other perfusion parameter values and BF,P-BV,Per pseudo-color map and generation time density curve(TDC).Each lesion was measured 3 times and the arithmetic mean was taken.Specimens were prepared by trained professional pathologists based on the ROI area after surgery.The microvessel density counts were referred to the weidner vascular count method.All collected data were analyzed using SPSS 22.0 software.Results:(1)The results of CT perfusion of thyroid nodules were compared: the vascular surface permeability(PMB value)of benign and malignant nodules group was statistically different(P <0.05),and the diagnostic efficiency of PMB was higher,when the nodule diameter was ≥1 cm.And the PMB value is >40.50,the sensitivity for malignancy is 100%,and the specificity is 69.56%.When the nodule diameter is less than 1 cm but greater than 0.5 cm and the PMB value is >11.32,the sensitivity for malignancy is 100%and the specificity is 51.85%.(2)Pathological microvessel count(MVD)of benign and malignant thyroid nodules was analyzed by one-way analysis of variance: when the diameter of malignant nodules was ≥1 cm,the microvessels in the nodules were more abundant than benign nodules(P<0.05).When the diameter of malignant nodules was less than 1 cm,there was no statistical difference between the nodules and benign nodules.(3)CT perfusion parameters(BF,BV,PMB)and pathological microvessel count(MVD)were analyzed by Pearson correlation analysis: malignant nodules were ≥1 cm in diameter,and PMB values were positively correlated with MVD values(r=0.63,P <0.05).The malignant nodules were less than 1 cm in diameter but greater than 0.5 cm.The BF value was positively correlated with the MVD value(r=0.61,P <0.05).Conclusion: 1.Double-low CT perfusion technique can obtain internal blood flow information of thyroid nodules,and has the highest diagnostic efficiency with PMB value,which can provide objective quantitative information of blood flow for clinical practice.2.The pathological type of thyroid nodules and the diameter of the nodules are related to the microvessel density in the nodules.3.The CT perfusion parameter value is related to the MVD value,which can indirectly reflect the number of microvessels in the nodule,thus early diagnosis of clinical thyroid nodules,which can guide clinical timely intervention and treatment,and provide certain value for tumor anti-vascular treatment. |
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