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目的：评价ＣＴ和临床触诊对甲状腺恶性肿瘤的诊断价值。方法：３０例甲状腺恶性肿瘤术前均进行 ＣＴ扫描和临床触诊检查，双盲法观察及分析影像所见，将其结果用卡方检验做统计学处理。结果：３０例甲状腺恶性肿瘤中ＣＴ和触诊的确诊率分别为 ８０％和 ４３． ３％。ＣＴ可确诊１１例经触诊无法明确的病变，经统计学分析，有显著性差异（Ｘ２＝ ４． ２３，Ｐ＜０．０５）。ＣＴ能准确显示肿瘤向周围结构侵犯；在诊断颈部转移性淋巴结的价值上，ＣＴ的敏感性、特异性和准确性均优于临床触诊（Ｐ＜０．０５）。结论：ＣＴ对甲状腺恶性肿瘤的术前定性诊断有较大的价值。ＣＴ在显示肿瘤向周围结构侵犯和局部淋巴结转移上明显优于临床触诊。同时联合多种诊断技术和综合分析对甲状腺恶性肿瘤的定性诊断、术式选择及预后具有重要的意义。
Objective: To evaluate the diagnostic value of CT and clinical palpation for thyroid malignancy. Methods: Thirty patients with thyroid malignancies underwent CT scans and clinical palpation examinations before operation. Double-blind methods were used to observe and analyze the images. The results were analyzed by chi-square test. Results: The diagnostic rate of CT and palpation in 30 cases of thyroid malignancy were 80% and 43. 3%. CT can be diagnosed in 11 cases that could not be definitively diagnosed by palpation. After statistical analysis, there was a significant difference (X2 = 4.23, P<0.05). CT can accurately show the invasion of the tumor to the surrounding structures; the sensitivity, specificity, and accuracy of CT are superior to those of clinical palpation in the diagnosis of cervical metastatic lymph nodes (P<0.05). Conclusion: CT has great value in the preoperative diagnosis of thyroid malignancy. CT was superior to clinical palpation in displaying tumor invasion to surrounding structures and regional lymph node metastasis. At the same time combined with a variety of diagnostic techniques and comprehensive analysis of the qualitative diagnosis of thyroid cancer, surgical selection and prognosis is of great significance.