二维超声特征对甲状腺结节性质的诊断价值

The value of ultrasonographic features on prediction of thyroid malignant nodules

目的探讨依据超声特点判断甲状腺结节良恶性的临床应用价值。方法对我院2008年1月至2012年12月就诊并手术治疗的甲状腺结节患者121例（212个结节）进行回顾性分析。查阅患者病历资料记录结节的超声特点及术后病理结果，分析超声特点与甲状腺结节良恶性间的关系。结果212个结节中恶性结节89个，占42．0％。单因素分析显示，与良性结节比较，甲状腺恶性结节超声表现中边界不清、实性结构、低回声和结节钙化等特点所致比例显著增高（P〈0．05）。Logistic回归分析显示边界不清（OR=3．02，P=0．02）和结节钙化（OR=3．66，P=0．01）是判断甲状腺结节的独立危险因素。根据贝叶斯定理，以结节边界不清和结节钙化诊断结节为恶性的敏感性分别为0．56（95％CI：0．44-0．68）和0．60（95％CI：0．49～0．69）：特异性为0．72（95％CI：0．64．0．80）和O．77（95％CI：0．69～0．84）。结论甲状腺结节的良恶性有其自身的超声特点，综合分析其影像特点对鉴别结节良恶性有一定的临床价值。

Objective To evaluate the diagnostic value of Doppler uhrasonography on predicting thyroid malig nant nodles. Methods One hundred and twenty-one patients （with 212 thyroid nodules） deetcted by Doppler ultra- sonography in our hospital from January 2008 to December 2010 were retrospectively analyzed. The relationship be tween ultrasonography features and thyroid nodules malignancy were evaluated before and after the surgery. Results Of 212 thyroid ndules, 89 were malignant nodules, which took parts in 42.0%. Single chi-square analysis demonstrat ed that ill-defined border, solid and hypoechogenicity calcification and blood flow around the nodule was much fre- quently observed in malignant nodules. And logistic regression showed that ill-defined border（OR=3.02, P=0.02） and calcification（OR=3.66, P=0.01） were the independent risk factors for malignancy. The diagnosis sensitivity and speci- ficity by ill-defined border were 0.56（95%CI： 0.44-0.68） and 0.72（95%CI： 0.64-0.80）; the diagnosis sensitivity and specificity by calcification were 0.60（95%CI： 0.49-0.69） and 0.77（95%CI： 0.69-0.84）. Conclution Benign or malig nant thyroid nodule has its own ultrasound characteristics, a comprehensive analysis of its imaging features differenti ating benign and malignant nodules have the certain clinical value.