Original Article
Combination of multiple CT signs in diagnosis of nodular goiters
Miaoping Zhu, Yanyan Shu, Zhijiang Han
Published 2016-04-04
Cite as Chin J Gen Pract, 2016, 15(4): 281-285. DOI: 10.3760/cma.j.issn.1671-7368.2016.04.010
Abstract
ObjectiveTo investigate the combination of multiple CT signs in diagnosis and differential diagnosis of nodular goiters (NGs).
MethodsThe CT images of 242 pathologically confirmed lesions (>10 mm in diameter) from 188 patients with nodular goiters were retrospectively reviewed. The CT signs, including regular shape, cystic degeneration, clearer enhancement margin, strong enhancement of nodular goiters were compared with those of 236 pathologically confirmed lesions (>10 mm in diameter) from 225 patients with papillary thyroid carcinomas (PTCs). The sensitivity, specificity and accuracy of different CT signs or their combination in diagnosis and differential diagnosis of NGs were analyzed.
ResultsRegular shape was present in 208 of 242 NGs (86.0%) and in 35 of 236 PTCs (14.8%) (χ2=241.804, P=0.000). Cystic degeneration was present in 143 of 242 NGs (59.1%) and 7 of 236 PTCs (3.0%) (χ2=174.783, P=0.000). Clearer enhancement margin was present in 192 of 242 NGs (79.3%) and in 51 of 236 PTCs (21.6%) (χ2=159.318, P=0.000). Strong enhancement was present in 41 of 242 NGs (16.9%) and in 3 of 236 PTCs (1.3%) (χ2=35.108, P=0.000). Regular shape showed the highest sensitivity and accuracy for diagnosis of NGs (86.0% and 85.6%), while strong enhancement showed the highest specificity (98.7%). The combination of regular shape and clearer enhancement margin showed the highest sensitivity and accuracy of 67.4% and 80.5%, respectively. The combination of strong enhancement with any of other signs showed the highest specificity of 100.0%. The combination of regular shape, cystic degeneration and clearer enhancement margin showed the highest sensitivity, specificity and accuracy of 45.5%, 99.6% and 72.2% respectively. The combing of 4 signs showed a sensitivity, specificity, and accuracy of 2.9%, 100.0% and 50.8%.
ConclusionCT scan is effective for diagnosis of NGs, and the combination of different CT signs can significantly improve the specificity and reduce the incidence of misdiagnosis to avoid unnecessary surgery.
Key words:
Thyroid carcinoma; Goiters, nodular; Computed tomography, Spiral computer
Contributor Information
Miaoping Zhu
Department of Radiology, Hangzhou Obstetrics and Gynecology Hospital, Hangzhou 310008, China
Yanyan Shu
Department of Radiology, the First People's Hospital of Xiaoshan District, Hangzhou 311201, China
Zhijiang Han
Department of Radiology, the First People's Hospital of Hangzhou, Hangzhou Center for Diagnosis and Treatment of Thyroid Disease, Hangzhou 310006, China
