彩色多普勒超声对甲状腺乳头状癌的诊断价值分析

Diagnostic value of color doppler ultrasound for papillary thyroid carcinoma

目的探讨彩色多普勒超声对甲状腺乳头状癌(PTC)的诊断价值。方法对经手术病理证实的115例PTC及129例甲状腺良性肿瘤的超声图像特征进行比较分析,采用χ2检验与Logistic回归分析影响诊断PTC的因素。结果彩色多普勒超声诊断PTC的准确性为82.07%,特异性为86.75%,其中边缘及回声的敏感度为87.20%和84.80%,纵横比、微小钙化的特异度为92.59%和86.75%。单因素分析显示,形态、边界、回声、微小钙化等结节超声特征是对鉴别诊断PTC有意义的特征变量;Logistic回归多因素分析显示,回声(OR=3.13,95%CI:1.58～6.19)和微小钙化(OR=2.03,95%CI:1.19～3.48)是诊断PTC的独立预测因素。结论彩色多普勒超声特征中的回声和微小钙化两项指标有助于提高诊断PTC的准确率。

Objective To explore the diagnostic value of color doppler ultrasound for papillary thyroid carcinoma （PTC）. Methods One hundred and fifteen cases with PTC and 129 cases with thyroid benign mass who were confirmed by pathology were analyzed comparatively with color doppler uhrasound. The chi-square test and multivariate logistic regression analysis were used to identify the prognostic factors. Results The sensitivity and specificity of ultrasound for the diagnosis of PTC was 82. 07% and 86. 75%. PTC could be diagnosed according to features detected by ultrasound,including mass shape, boundary, echo, calcification and so on. The sensitivity of boundary and echo was 87. 20% and 84. 80% ;and the specificity of aspect ratio and microcalcification was 92. 59% and 86. 75%. The result ofx2 analysis was meaningful ultrasonic features including mass shape, boundary, echo and microealcification. The result of Logistic regression analysis was echo and microcalcification with significant differences in the prognostic factors in PTC. The odd ratio （OR） of echo was 3. 13 （95 % CI ： 1.58-6. 19, P = 0. 001 ）. The OR of microcalcification was 2. 03 （ 95% CI ： 1.19-3.48, P = 0. 02）. Conclusion Two dimensional ultrasound is basic examination in diagnosis of PTC, microcalcifieation and low echoes in high frequency ultrasonography may be an important diagnostic indicator for PTC, which can be useful in differentiating PTC from benign thyroid mass.