Objective:To assess the value of the combination of sonography with CT in the diagnosis and differential diagnosis of thyroid follicular lesions.Methods:CT and sonography findings of 135 lesions in 122 patients with thyroid follicular lesions were retrospectively analyzed,all of the patients had pathologic diagnosis.One hundred and twenty-two leisions in 109 patients with adenomatoid noduler goiter (ANG),13 lesions in 13 patients with follicular carcinoma (FC) were included.A round or oval shape lesion which possesses internal homogeneous echo and a clear boundary acoustic halo was considered as characteristic follicular adenomatoid nodule (FAN) in sonography,and a lesion which possesses higher enhancement than thyroid was considered as characteristic FAN on CT.The sensibility and specificity of the characteristic sonographic sign,the computed tomgrphic sign,and the combiniation of sonogrphic and computed tomgrphic sign were analyzed respectively in the diagnosis of FAN.The characteristic sonographic sign,the computed tomgrphic sign,and ring calcification in FAN and FC were analyzed.Results:Among the 135 lesions in the group,1 FAN and 2 FC were excluded because of acoustic attenuation of ring calification,the sensibility and specificity of the characteristic sonographic sign was 72.7％(88/121) and 54.5％(6/11) respectively; the sensibility and specificity of the characteristic computed tomgrphic sign was 68.9％(84/122) and 84.6％(11/13) respectively; and of the combiniation of sonogrphic and computed tomgrphic sign was 91.0％(111/122) and 61.5％(8/13).There was no statistical difference in the characteristic sonographic sign between FAN and FC (P＞0.05),but had statistical difference in the characteristic computed tomgrphic sign and ring calcification (P＜0.05).Conclusions:CT has higher specificity than sonography in the diagnosis of FAN,and the combination of sonography with CT can improve the specificity in the diagnosis of FAN; ring calcification and lower enhancement than the normal surrounding thyroid are helpful for the diagnosis of FC.%目的:探讨超声和CT的联合应用在甲状腺滤泡性病变诊断和鉴别诊断中的价值.方法:搜集经病理证实的122例135枚甲状腺滤泡性病变的CT和超声资料,其中包括109例122枚腺瘤性病变(FAN)、13例13枚滤泡细胞癌(FC).以同时具备回声均匀、周围低回声晕环、边缘规则作为典型的超声诊断FAN的征象,以强化程度高于周围甲状腺组织作为典型的CT诊断FAN的征象,分别观察典型的超声、CT和超声与CT征象联合在FAN诊断中的敏感性和特异性,对具备典型超声征象、典型CT征象和环状钙化的FAN与FC进行统计分析.结果:因环状钙化后方声衰显著而影响观察的1枚FAN和2枚FC除外,典型超声征象的敏感性为72.7％ (88/121),特异性为54.5％ (6/11)；典型CT征象的敏感性为68.9％(84/122),特异性为84.6％(11/13)；典型超声与CT征象联合在FAN诊断中的敏感性为91.0％(111/122),特异性为61.5％(8/13).典型超声征象在FAN与FC诊断中无统计学差异,典型CT征象及环状钙化在FAN与FC诊断上具有统计学差异.结论:CT在FAN的诊断中较超声具有更高的特异性,二者的联合应用可以明显提高FAN的敏感性；环状钙化及CT强化程度低于周围甲状腺组织有助于FC的诊断.
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