Clinical Value Of320-slice Spiral CT In Diagnosis And Antidiastole Of Thyroid Nodular

Objective Analyse imaging features of benign and malignant thyroidnodules with320-slice spiral CT， evaluate the value of320-slice spiralCT in diagnosis and antidiastole of thyroid nodular， provide morenon-invasive examination methods， detailed data and intuitive imagematerial for the clinical diagnosis and treatment. Explore the correlation ofthe tumor angiogenesis and the malignancy grade and metastasis oftumor， through multifaceted display of thyroid nodules feeding arterywith CTA.Methods In this study， we collected218nodules in160patients，analysed the imaging characteristics of benign and malignant thyroidnodules feeding artery through a variety of post-processing techniques， combined with the original image. Explored the correlation of the tumorangiogenesis and the malignancy grade and metastasis of tumor bystatisticing the feeding artery branch number of thyroid nodules andobserving the line feed of vessels. By observing the plain CT scan，enhanced and vascular three-dimensional reconstruction imagecharacteristics of benign and malignant thyroid nodules， evaluated thesensitivity， specificity and accuracy of CT in benign and malignantthyroid nodules diagnosis comparing with the gold standard (pathologydiagnostic results). ADW4.5workstation were used for data analysis.SPSS18.0software package was applied to statistical analysis of the datain each group.Results1. In the plain CT scan the changes of the thyroid noduleshape， boundary and calcification have statistically significant， P <0.05.2. After enhanced scan，72benign thyroid nodules had homogeneous enhancement，30benign thyroid nodules complete ring enhancement，91.07%of the total benign nodules had both of the enhancement patterns.Malignant nodules of the thyroid；42performed "tumor intensive theresidual circle levy"，36were "Peninsula like" enhancement，16caseswere nodular enhancement， this three accounted for88.68%of the totalmalignant nodules. Nodule enhancement pattern was statisticallysignificant in the antidiastole of benign and malignant thyroid nodules (P=0.000， P <0.05).3．MSCT of thyroid cancer adjacent tissue invasion and lymph nodemetastasis diagnosed with high accuracy, the correct rate of87.50%-100%.4. CT angiography three-dimensional reconstruction，post-processing images can clearly show the feeding artery of the172cases，66patients with benign nodules can show the feeding artery， the blood supply of benign nodules was characterized by few terminalbranches， the average diameter of the feeding artery was1.60mm±0.33mm. Malignant nodules all show feeding arteries， the blood supplyof malignant nodules was characterized by more terminal branches，theaverage diameter of the feeding artery was1.92mm±0.36mm. In thisstudy， we concluded that the number of terminal vascular branches inmalignant nodules had a high correlation with the stage of tumor.5. Plain CT scan， enhanced and CTA diagnosed thyroid benignnodules116cases， pathologically confirmed8cases of malignantlesions； CT diagnosed thyroid malignant nodules102cases，pathologically confirmed4cases of benign lesions， its sensitivity，specificity and correctness were96.43%，92.45%，94.50%.Conclusion1. MSCT have a very good prospect in the diagnosis andantidiastole of thyroid benign and malignant nodules，provide a reference value for preoperative diagnosis of clinical.2．MSCT has a very high correctness of the diagnosis of thyroidcancer adjacent tissue invasion and lymph node metastasis， the correctrate was between75%and100%. The MSCT images can clearly show theinvasion situation of the tissue surrounding the nodules， especiallyMSCTA can able to visually observe the violation degree of thesurrounding macro vascular， and it could help clinicians choose the righttreatment program or surgery as soon as possible.3. Vascular density and malignant degree of the tumor nodules werepositively correlated， vascular intensive， rich， more branching andgoing line circuity can be used as diagnosis basis for thyroid cancer.Tumor angiogenesis determining the rate of tumor growth and metastasis，the CTA showed degree of tumor vasculature growth and TNMclassification series were positively correlated， that means tumor angiogenesis is proportional to the malignant degree of tumor， and it alsocan auxiliary diagnose the possibility of tumor metastasis.