Objective To evaluate the value of enhanced CT in the diagnosis of malignant thyroid nodules. Methods The databases,including PubMed,EMBASE,Cochrane Library,CNKI,Wangfang,CQVIP,were searched to collect the prospective literature on evaluation the value of enhanced CT in the diagnosis of malignant thyroid nodules before June 2016. Set up inclusion and exclusion criteria,then extracted the relevant data to Meta analysis after the quality evaluation of the literature. Results A total of eight prospective studies were included in this study. There were 868 patients in this study,containing 1162 nodules. 707 of which were benign nodules,and 455 were malignant nodules. The sum of sensitivity,specificity, positive likelihood ratio and negative likelihood ratio and diagnostic odds ratio of enhanced CT in the diagnosis of malignant thyroid nodule were: 0.75(0.67-0.82)、0.86(0.80-0.90)、6.25(2.44-16.04)、0.31(0.16-0.61)and 32.77(14.45-74.31). The summary receiver-operating characteristic curve was conducted and the area under the curve was(0.9196±0.0254). In addition,several enhanced CT features have been found to help to determine whether nodules was malignant or not,like microcalcification,the anteroposterior dimension to the transverse dimension(AP/T ratio)of greater than 1.0 Etc. Conclusions Enhanced CT has high diagnostic accuracy in detecting malignant thyroid nodule,helping the differential diagnosis of benign and malignant thyroid nodule.%目的 评价增强CT对恶性甲状腺结节的诊断价值.方法 选取PubMed、EMBASE、Cochrane Library、中国知网、万方、维普等数据库,检索2016年6月前发表的有关评价增强CT对恶性甲状腺结节诊断价值的前瞻性研究.设立纳入和排除标准,对纳入的文献进行质量评价后提取相关数据进行Meta分析.结果 共有8篇前瞻性研究纳入本次研究.总计868例患者,1162个结节,其中良性结节707个,恶性结节455个.增强CT诊断甲状腺结节为恶性的汇总灵敏度、特异度、阳性似然比、阴性似然比和诊断比值比分别为:0.75(0.67～0.82)、0.86(0.80～0.90)、6.25(2.44～16.04)、0.31(0.16～0.61)、32.77(14.45～74.31),综合受试者工作特征曲线(SROC)分析显示诊断准确性为(0.9196±0.0254).另外,增强CT呈现的甲状腺结节微钙化、前后径大于左右径等对判断结节的恶性与否也具有一定的帮助.结论 增强CT对恶性甲状腺结节具有较高的诊断价值,有助于甲状腺结节良恶性的鉴别诊断.
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