甲状腺单发结节的超声诊断

Diagnosis of solitary thyroid nodules with ultrasonography

目的探讨超声对甲状腺单发结节的诊断价值。方法回顾性分析173例经手术病理证实的甲状腺单发结节,将其术前超声结果与术后病理作比较,并分析相应声像图特点。结果本组中超声对良性结节的诊断符合率为93.7%,对恶性结节的诊断符合率为60.7%。有5例未提示良恶性,占2.9%。良性结节中,超声对甲状腺腺瘤的诊断符合率为60.7%(34/56),腺瘤外其他良性结节病变,28.4%(21/74)误诊为恶性结节,2.7%(2/74)误诊为甲状腺腺瘤,4.1%(3/74)性质待定(不确定良恶性)。良恶性结节声像图在纵/横比、内部及后方回声、包膜、钙化、颈部淋巴结等方面差异均有统计学意义(p<0.05),而在结节的边界、内部血流以及血流阻力指数(RI)等方面差异无统计学意义(p>0.05)。结论超声对甲状腺单发结节性病变有较高的诊断价值。

Objective To investigate the value of ultrasonography（US） in the diagnosis of solitary thyroid nodules. Methods The US features of 173 cases with solitary thyroid nodules confirmed by surgery and pathology were retrospectively analyzed and compared with the histological findings. Results In this research, the accurate diagnostic rate of US was 93.7% in benign thyroid nodules, and 60.7% in malignant thyroid nodules,while 5 cases（2.9%） were undetermined with US. In the benign group, the diagnostic accuracy was 60.7%（34/56） in thyroid adenomas.In the other benign nodules, 28.4%（21/74） were misdiagnosed as malignant nodules,2.7%（2/74） were misdiagnosed as adenomas,and 4.1%（3/74） were undetermined. There was statistical significance in the anteroposterior/transverse diameter ratio,echogenicity, capsule, calcification and cervical lymph nodes between benign and malignant nodules（ p 〈 0.05）.However,there were no significant differences in the border, intranodular blood flow,and resistance index （RI）between benign and malignant nodules（p 〉 0.05）. Conclusions Ultrasonography is valuable in the diagnosis of solitary thyroid nodules.