Value of CT in evaluating the risk of benign and malignant thyroid nodules

Abstract

Objective: To evaluate the value of CT in the risk assessment of thyroid benign nodules (BN) and malignant nodules (MN). Methods: The CT signs of 461 pieces of MN in 447 cases and 548 pieces of BN in 484 cases were retrospectively analyzed, the diagnoses were confirmed by histology, including nodular morphology, cookie bite sign, microcalcification, enhanced range narrow/blurred, cystic changes and enhanced.The signs of CT were analyzed by univariate and multivariate regression analysis.The positive CT signs were calculated to assess sensitivity and specificity in the diagnosis of BN and MN. Results: Univariate and multivariate analysis showed that irregular nodular morphology (χ(2)=509.263, P<0.001, OR=5.297), cookie bite sign (χ(2)=504.619, P<0.001, OR=3.467), microcalcification (χ(2)=97.793, P<0.001, OR=1.730), enhanced range reduction/blur (χ(2)=361.967, P<0.001, OR=5.729) were more common in MN.Cysts changes (χ(2)=223.208, P<0.001, OR=7.537) and enhancement signs (χ(2)=65.983, P<0.001, OR=10.782) were more common in BN.The sensitivity and specificity of irregular nodular morphology in the diagnosis of MN were 80.5% and 90%, those in cookie bite sign were 74.2% and 94.3%, microcalcification were 35.6% and 90.1%, enhanced range reduction/blur were 80.7% and 79.4%.The sensitivity and specificity of capsule-based and high-enhanced BN diagnosis were 42.2% and 98.1%, 19.0% and 97.4%, respectively. Conclusions: Irregular shape, cookie bite sign, microcalcification and enhanced range of narrowing/blur are significant CT signs in the assessment of MN, and cystic changes and enhancement are significant CT signs in the evaluation of BN.The diagnostic efficiency of various CT signs varies greatly, and combination of multiple CT signs can improve the diagnostic efficiency.