The Value Of Energy Spectrum CT In The Diagnosis Of Benign And Malignant Nodules In The Background Of Hashimoto’s Thyroiditis

Objective:Analyze the nodules in the background of Hashimoto’s thyroiditis(HT)by energy spectrum CT,and obtain the morphological characteristics of benign and malignant nodules in the background of HT and the characteristics under the parameters of each energy spectrum CT,to analysis the value of energy spectrum CT in the differential diagnosis of nodules with HT.Method:Collected 46 patients with Hashimoto’s thyroiditis with nodules,a total of 53 nodules,and divided them into two groups,benign(32)and malignant(21)based on the pathological results.The patients were plain scanned,contrast-enhanced scanned by energy spectrum CT.Firstly,observed the morphology of benign and malignant nodules,whether there were cake biting signs,microcalcifications,and whether the scope of the nodules was reduced or blurred after enhancement.Secondly,the ROI was delineated for the nodules,the IC in that three phases were obtained,and the NIC of the nodules in the arterial and venous phases was calculated.Used single energy imaging to get the energy spectrum curve of the nodule.A chi-square test was applied to the morphological feature data and an independent sample t-test was used for the energy spectrum data to determine if there was a statistical difference.Diagnostic effect that combined the two methods was analyzed by logistic regression analysis.Draw a ROC of the subject.Result:Compared with benign nodules,malignant nodules were more prone to irregular shapes,cake-biting signs,microcalcifications,and reduced or blurred areas after enhancement.The difference was statistically significant.The sensitivity of the diagnosis of malignant nodules was 52.4% and 66.7%,57.1%,66.7%;the specificity was 87.5%,78.1%,75.0%,71.9%.The IC and the λHU of malignant nodules during plain scan were lower than those of benign nodules,and the differences were statistically significant.The sensitivity was 81.0%,85.7%,and the specificity was68.7%,62.5%.The arterial IC,NIC,and λHU of malignant nodules were lower than those of benign nodules,and the differences were statistically significant.The sensitivity was 66.7%,85.7%,and 61.9%,and the specificity was 88.4%,68.7%,and87.5%.The sensitivity of combined diagnosis of morphological features and energy spectrum CT parameters was 95.2%,and the specificity was 96.9%.Conclusion: The characteristics of nodule morphology,cake biting sign,microcalcification,and narrowing/fuzziness after enhancement under the background of HT all have a good diagnostic efficiency for the differential diagnosis of benign and malignant nodules.Nodules’ IC,λHU in the plain and arterial phase,and NIC in the arterial phase have good differential diagnosis performance for benign and malignant nodules under the background of HT.The combined differential diagnosis of nodules in the background of HT by morphological characteristics and energy spectrum CT parameters under energy spectrum CT is significantly better than the diagnostic efficiency of the two alone.In summary,energy spectrum CT has a good value in the differential diagnosis of benign and malignant nodules under the background of HT.