Analysis of the clinical value of spectral CT in diagnosing the nature of thyroid nodules
10.3760/cma.j.cn115807-20250521-00138
- VernacularTitle:能谱CT诊断甲状腺结节性质的临床价值分析
- Author:
Yuzhou LI
1
;
Hongrui JIN
;
Yuan SUI
;
Guangyao LIN
Author Information
1. 商丘市第一人民医院CT室，商丘 476000
- Publication Type:Journal Article
- Keywords:
Thyroid nodule;
Spectral CT;
CT features;
Quantitative parameters;
Lymph node metastasis
- From:
Chinese Journal of Endocrine Surgery
2025;19(5):709-714
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.
