Clinical Study Combined Ultrasound And CT On Diagnosis Of Thyroid Calcification Nodules

Objective: To analyze the relationships between diferent types of calcification and benign and malignant thyroid nodules,compare the advantages and disadvantages of CT and ultrasound in the diagnosis of thyroid calcified nodules,and explore the clinical significance of CT combined with ultrasound in the diagnosis of benign and malignant calcified thyroid nodules.Methods: In this study,38 patients with thyroid nodules who underwent surgery and obtained pathological data in handan first hospital from September 2018 to December 2019 were selected.A total of 52 thyroid calcified nodules were examined by CT and ultrasound.With pathological results as the gold standard,the relationships between calcification,micro-calcification,annular calcification,coarse calcification and benign and malignant thyroid nodules were analyzed.CT and ultrasonic signs of thyroid calcified nodules were analyzed,and independent risk signs of thyroid malignant nodules were screened out by multivariate binary logistic regression analysis.The value of CT,ultrasound and their combination in the diagnosis of benign and malignant calcified thyroid nodules was investigated.Results:(1)The malignant rates of thyroid calcified nodules,microcalcified nodules,and coarse calcified nodules were 63.46%,66.67%,and 56.25%,respectively.(2)The calcification detection rate of thyroid nodules,malignant and benign nodules by ultrasound were higher than that of CT(P<0.05).Clearer borderline around coarse calcifications on enhanced CT than on plain CT was helpful for the diagnosis of benign calcifications.(3)The malignant signs of calcified thyroid nodules in ultrasound included mainly hypoechoic,irregular morpholopy,blurred boundary,anteroposterior and transverse diameter ratio(A/T)?1.Cystic predominance is the ultrasound sign of benign nodules.In contrast CT,the malignant signs of thyroid nodules included bite cake syndrome,blurred boundary,irregular shape,enhanced rang reduction/blur.High enhancement have significant value to diagnose BCNS.The multivariate logistic analysis showed that irregular morpholopy,A/T?1 are independent US risk factors for MCNS.Bite cake syndrome,irregular shape,blurred boundary,enhanced rang reduction/blur are independent CT risk factors for MCNS.(4)nodules with microcalcifications between CT and ultrasound.The accuracy of CT was higher thanthat of ultrasound in the diagnosis of thyroid nodules with coarse calcifications(P>0.05).The accuracy of CT in diagnosing coarse calcified nodules was higher than that of ultrasound(P<0.05).(5)All the three methods could be used for the diagnosis of MCNS.(6)Compared with pathology,CT and ultrasound showed a general consistency in diagnosis,with Kappa ranging from 0.4 to 0.75.CT combined with ultrasound had a good consistency in diagnosis,and Kappa?0.75.(7)The accuracy of CT combined with ultrasound(94.23%)was higher than that of CT or ultrasound alone in the diagnosis of benign and malignant thyroid nodules(P<0.05).Conclusions:(1)The patients with thyroid nodules combined with micro-calcifications should be highly aware of the possibility of thyroid cancer,and the patients with thyroid nodules combined with coarse calcifications should not ignore the possibility of malignancy.(2)The detection rate of calcifications by ultrasound is higher than that by CT.(3)The accuracy of CT is higher than that of ultrasound in the diagnosis of coarse calcification nodules.(4)Multiple signs of CT and ultrasound are helpful for the differential diagnosis of benign and malignant thyroid calcification nodules.(5)CT and ultrasound have certain advantages in distinguishing benign and malignant thyroid calcified nodules,but both have disadvantages.Combining the two kinds of inspection with complementary advantages greatly improves the accuracy of preoperative diagnosis.