Application of energy spectrum CT quantitative analysis in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis

doi:10.11958/20250052

Abstract

Abstract:

Objective To explore the application value of energy spectrum CT quantitative analysis in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis. Methods A total of 100 patients with thyroid nodules screened by ultrasound were selected as the study subjects. They were divided into the benign group (n=42) and the malignant group (n=58) according to pathological results. Patients in the malignant group were sub-divided into the metastasis group (n=26) and the non-metastasis group (n=32) according to the presence or absence of cervical lymph node metastasis. All patients received energy spectrum CT examination. The iodine concentration (IC), normalized iodine concentration (NIC) and the slope of the spectral Hounsfield unit curve (λHU) were measured. The receiver operating characteristic (ROC) curve was used to analyze the application value of energy spectrum CT quantitation in diagnosing malignant thyroid nodules and evaluating cervical lymph node metastasis. Results There were statistically significant differences in CT features (shape, edge, cystic changes and surrounding tissue invasion) between benign and malignant thyroid nodules (P<0.05). However, there were no statistically significant differences in the maximum diameter, number, enhancement degree and calcification (P>0.05). IC_lesion, NIC and λHU were lower in the benign group than those of the malignant group. IC_lesion, NIC and λHU of the metastasis group were lower than those of the non-metastasis group (P<0.05). ROC curve analysis results showed that the AUCs, specificity, sensitivity and Youden index of the combination of IC_lesion, NIC and λHU for diagnosing malignant thyroid nodules and evaluating cervical lymph node metastasis were higher than those of each parameter (P<0.05). Conclusion Energy spectrum CT quantitative analysis is of high value in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis.

Key words: thyroid nodule, neck, lymphatic metastasis, energy spectrum CT quantitative analysis

CLC Number:

R736.1，R445.9

Figures/Tables 7

References 19

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组别		n	最大直径/mm	数目（单发/ 多发）		形态（规则/ 不规则）			边缘（清楚/ 模糊）
良性组		42	2.36±0.41	18/24		31/11			34/8
恶性组		58	2.28±0.52	30/28		22/36			16/42
t或χ²			0.828	0.767		12.588^＊			27.750^＊
组别	强化程度（轻中度强化/显著强化）				钙化（有/无）		囊变（有/无）	周围组织侵犯（有/无）
良性组	20/22				17/25		25/17	5/37
恶性组	31/27				20/38		10/48	32/26
χ²	0.331				0.375		19.143^＊	19.564^＊

组别		n	最大直径/mm	数目（单发/ 多发）		形态（规则/ 不规则）			边缘（清楚/ 模糊）
良性组		42	2.36±0.41	18/24		31/11			34/8
恶性组		58	2.28±0.52	30/28		22/36			16/42
t或χ²			0.828	0.767		12.588^＊			27.750^＊
组别	强化程度（轻中度强化/显著强化）				钙化（有/无）		囊变（有/无）	周围组织侵犯（有/无）
良性组	20/22				17/25		25/17	5/37
恶性组	31/27				20/38		10/48	32/26
χ²	0.331				0.375		19.143^＊	19.564^＊

组别	n	IC_病灶/（g/L）	NIC/（g/L）	λHU/（HU/KeV）
良性组	42	3.65±0.45	0.73±0.12	3.58±0.40
恶性组	58	2.75±0.37	0.62±0.09	3.07±0.35
t		10.872^＊	5.152^＊	6.751^＊

组别	n	IC_病灶/（g/L）	NIC/（g/L）	λHU/（HU/KeV）
良性组	42	3.65±0.45	0.73±0.12	3.58±0.40
恶性组	58	2.75±0.37	0.62±0.09	3.07±0.35
t		10.872^＊	5.152^＊	6.751^＊

组别	n	IC_病灶/（g/L）	NIC/（g/L）	λHU/（HU/KeV）
未转移组	26	3.14±0.41	0.70±0.11	3.42±0.42
转移组	32	2.42±0.32	0.57±0.08	2.75±0.38
t		10.151^＊	4.002^＊	4.415^＊