Multivariate analysis of various CT signs of papillary thyroid microcarcinoma

ZHANG Jiaming; HAN Zhijiang

doi:10.19300/j.2017.L4245

Abstract：Objective Investigate the diagnostic value of a variety of CT signs in papillary thyroid microcarcinoma (PTMC). Methods There were 231 cases of histologically confirmed 249 PTMC and 205 cases of 266 micronodular goiters (MNG) with the diameter≤1.0 cm were retrospectively analyzed. CT signs, including nodular shape, cake-biting sign, microcalcification, and enhanced shrinkage/blurring, were fed into multivariate Logistic regression analysis, the sensitivity and specificity of each relevant CT sign and their combinations in the diagnosis of PTMC were calculated. Results Multivariate Logistic regression analysis showed irregular nodules, cake biting sign and enhanced shinkage/blurring were often shown in PTMC(P<0.05);OR values were 9.009(95%CI:4.709-17.236), 10.372(95%CI:5.495-19.579) and 12.623 (95%CI:6.910-23.057), respectively. Microcalcification was not statistically significant(P>0.05) in the multivariate analysis. Among the relevant signs, the irregular shape had highest sensitivity (90.4%), and the cake-biting sign had the highest specificity(90.2%). Combining irregular nodules and enhanced shinkage/blurring achieved highest sensitivity (81.9%), and combining irregular shape and cake-biting sign achieved the highest specificity (95.4%). When three signs were combined, the sensitivity and specificity were 59.4%and 96.6%respectively. Conclusion The irregular shape, cake-biting sign, and enhanced shinkage/blurring had important value in the diagnosis of PTMC. The combination of the 3 signs can further enhance the d PTMC diagnostic specificity, thereby reducing the incidence of misdiagnosis.