高频彩色多普勒超声检查预测甲状腺恶性结节的准确性

Study of diagnostic accuracy of high frequency ultrasound in predicting malignant thyroid nodules

目的比较甲状腺良恶性结节的各项高频彩色多普勒超声声像特征,并分析其对于预测甲状腺恶性结节的准确性。方法2016年7月至2019年4月在安徽医科大学第一附属医院行甲状腺结节手术的病人401例,均已行术前超声检查及术后病理确认。比较良恶性结节术前高频彩色多普勒超声声像特征,分别计算超声诊断恶性结节的灵敏度,特异度,阳性与阴性预测值及准确率,以组织学(病理诊断)作为参考标准。结果共诊断甲状腺结节425个,其中良性结节245个,恶性180个。结节纵横比≥1、边缘毛糙、极低回声及微钙化诊断甲状腺恶性结节的准确率均超过70.0%。当结节为极低回声时,并同时出现其他恶性声像特点,诊断恶性结节的准确率达到79.8%。结论在当前技术条件下,结节高频彩色多普勒超声形态、边缘、内部回声强度及是否存在钙化的声像特征对鉴别甲状腺结节良、恶性有意义,并在预测恶性结节方面具有较高的准确性。

Objective To compare the ultrasonic image characteristics of benign and malignant thyroid nodules and analyze its accuracy in predicting malignant thyroid nodules.Methods Four hundred and one patients undergone surgery of thyroid nodules in The First Affiliated Hospital of Anhui Medical University from July 2016 to April 2019 were confirmed by preoperative ultrasonic diagnosis and postoperative pathology.The characteristics of the benign and malignant thyroid nodules on ultrasonic images were compared.The sensitivity,specificity,positive predictive values,negative predictive values and accuracy of ultrasound diagnosis of malignant thyroid nodules were evaluated by using tissue diagnosis as the reference standard.Results A total of 425 thyroid nodules were diagnosed,including 245 benign nodules and 180 malignant nodules.The diagnostic accuracy of malignant thyroid nodules exceeded 70.0%according to the following characteristics:the nodule aspect ratio≥1,rough edges,extremely low echo and microcalcification.When the nodules are extremely hypoechoic,and other malignant audiovisual features appear at the same time,the diagnostic accuracy of malignant nodules will reach 79.8%.Conclusion Under the current technical conditions,the shape,margin,echogenicity,and presence of calcification of thyroid nodules with ultrasonic images has significance in the discrimination of malignant from benign nodules and has high diagnostic accuracy in predicting malignant nodules.