The Diagnostic Value Of Spectral CT Combined With TIRADS Classification On Thyroid Nodules

Objective:Through the spectral CT scan of thyroid nodules,a series of energy spectrum parameters of benign and malignant nodules were obtained.The correlation between the measurement results and pathology was studied.The TIRADS classification of these nodules was adjusted.The difference of diagnostic efficacy before and after the adjustment was analyzed,so as to make a better scheme for the accurate diagnosis of thyroid nodules.Methods : Who underwent energy spectrum enhanced CT scan,ultrasound examination,operation or puncture biopsy and confirmed by pathology.The patients were divided into two groups: There were 30 benign throid nodules and 37 malignant throid nodules.The iodine concentration in plain scan,arterial phase and venous phase was obtained by detecting benign and malignant thyroid nodules with energy spectral CT,and then the IC in common carotid artery on the same level in the enhanced image was measured to get the standardized iodine concentration(NIC).The slope of the spectral HU curve(?HU)was obtained from the single energy diagram.The TIRADS classification of nodules was adjusted by combining the NIC,?HU values with pathological results.Results:(1)The standardized iodine concentration(NIC)of benign nodules in arterial and venous phases was higher than that of malignant nodules,and the difference was statistically significant.(2)The slope of the spectral HU curve(?HU)of Benign nodules in plain scan,arterial and venous phases was higher than that of malignant nodules.(3)The best threshold value of benign and malignant nodules was obtained by ROC curve correlation analysis of NIC,? Hu values and pathological results respectively.The NIC threshold was 0.31 in arterial phase and ?Hu threshold was 0.56 in plain scan.(4)the TIRADS classification of the nodules was adjusted by the optimal NIC and Hu values,it is concluded that the sensitivity and specificity are improved after adjustment.Conclusion:In energy spectral CT imaging,NIC and ?HU have certain diagnostic value for differentiating benign and malignant thyroid nodules,that is,benign nodules NIC and ?HU are higher than malignant nodules in the corresponding period.Combined with the pathological results,the corresponding critical value was obtained.Based on the above conclusion(the optimal critical value),the TIRADS classification of nodules was adjusted again,and the adjusted TIRADS classification was more accurate.