CT理论与应用研究2025，Vol.34Issue(1)：31-36,6.DOI:10.15953/j.ctta.2024.155
基于双能CT列线图模型预测甲状腺乳头状癌淋巴结转移的研究
Study on the Nomogram Model Based on Dual-energy Computed Tomography for Predicting Lymph Node Metastasis in Papillary Thyroid Carcinoma
摘要
Abstract
Objective:This study aimed to evaluate the effectiveness of a nomogram model based on dual-energy computed tomography(CT)quantitative parameters combined with clinical information for distinguishing metastatic from non-metastatic lymph nodes in patients with papillary thyroid carcinoma(PTC).Methods:This retrospective study was conducted in 103 patients with PTC from 2021 to 2023.Each patient underwent preoperative neck dual-energy-enhanced CT,and postoperative pathological results revealed 105 lymph nodes as metastatic and 136 as non-metastatic.Parameters,such as iodine concentration(IC),in the arterial phase,lymph node shape,short diameter,margin,degree of enhancement,cystic changes,calcification,arterial phase enhancement pattern,and thyroid nodule capsule integrity were analyzed.Univariate and multivariate logistic regression analyses identified independent risk factors for lymph node metastasis that were incorporated into the nomogram.The model performance was evaluated using a calibration curve.Results:Multivariate logistic regression analysis showed IC in the arterial phase≥2.6 mg/mL,significant arterial phase enhancement,uneven arterial phase enhancement pattern,diameter≥10 mm,unclear margins,irregular shape,and incomplete thyroid nodule capsule as independent risk factors for lymph node metastasis.The nomogram achieved an area under the curve of 0.996(95%confidence interval(CI);0.993～0.996)with a cutoff value of 0.09,sensitivity of 99%,and specificity of 95%.Conclusion:The dual-energy CT-based nomogram demonstrated a significant clinical value in the preoperative assessment of lymph node metastasis in patients with PTC,potentially assisting in the formulation of individualized surgical plans.关键词
双能量CT/甲状腺肿瘤/列线图/颈部淋巴结转移Key words
dual-energy CT/thyroid tumors/nomogram/cervical lymph node metastasis分类
医药卫生引用本文复制引用
高波,崔新悦,张婧彬,米惠枝,孙海乔,李晓会,吴佳星,张柯欣,王少彤,苏轩..基于双能CT列线图模型预测甲状腺乳头状癌淋巴结转移的研究[J].CT理论与应用研究,2025,34(1):31-36,6.基金项目
陕西省"双链"融合国家医学中心医工交叉项目(微剂量CT算法应用验证(2021LL-JB-06)). （微剂量CT算法应用验证(2021LL-JB-06）
