超声在甲状腺结节诊断中的应用

Application of ultrasound in diagnosis of thyroid nodular disease

目的 探讨超声在甲状腺结节鉴别诊断中的应用价值.方法 对本院2010年至2011年甲状腺结节患者87例进行超声检查,其中良性结节23例,恶性结节64例,对甲状腺良恶性结节的内部回声、边界、大小、形态、微钙化、血液供应和纵横比等超声指标采用单因素及多因素非条件Logistic回归分析,找出对判断良恶性甲状腺结节最具诊断价值的超声指标.结果 甲状腺恶性结节超声特征多为低回声、边界不清、形态不规则、微钙化、高血供、纵横比＞1；良性结节的超声特征多为高、等、混合回声及无回声、边界清、形态规则、低血供、纵横比≤1.两组超声指标比较差异均有统计学意义（P＜0.05）.经多因素非条件Logistic回归分析显示,形态及微钙化超声影像对判断良恶性甲状腺结节最具有诊断价值,EXP（B）分别是20.12,19.14.结论 超声检查有助于甲状腺结节的诊断,有助于区分甲状腺结节的良、恶性,为临床诊治提供依据.

Objective To explore the diagnostic value of ultrasound in thyroid nodular disease. Methods Eighty-seven patients with thyroid nodule in hospital from 2010 -2011 were taken uhrasound examination, including 23 cases with benign nodules and 64 cases with malignant nodules. Univariate analysis and mutivariate Logistic regression analysis were taken to test the ultrasonic index （internal echo, boundary, size, shape, microcalcifications, and aspect ratio） for discovery of the best diagnostic ultrasonic index to identify benign and malignant nodules. Results The ultrasound in the patients with malignant thyroid nodules showed the hypoecho, unclear border, irregular shape, microcalcifications, low blood supply, the aspect ratio 〉 1. The ultrasound in the patients with benign thyroid nodules showed high or equal echo, clear border, regular shape, high blood supply; and the aspect ratio ~〈 1. The ultrasonic in- dices between two groups had statistically significant difference （ P 〈 0. 05 ）. The shape and microcalcifications were the best ultrason- ic diagnostic index to indentify the benign and malignant nodules with an EXP（B） 20. 12 and 19. 14, respectively. Conclusions The ultrasound is helpful in the diagnosis of thyroid nodular disease and identification of benign and malignant thyroid nodules. The ultra- sonic images are the basic data for the clinical diagnosis of thyroid nodules.