彩色多普勒超声对甲状腺良恶性结节的诊断价值

The Diagnostic Value of Color Doppler Ultrasound for Malignant Nodules

目的探讨彩色多普勒超声对甲状腺良性结节的诊断价值。方法回顾性分析2009年6月至2013年8月在上海市第十人民医院接受手术治疗的78例甲状腺结节患者（178个结节）的临床资料,根据甲状腺结节的良恶性分为恶性组71个和良性组107个,分析甲状腺良恶性结节的超声特点。结果甲状腺彩色多普勒超声恶性结节的边界、结节性质、回声性质及结节钙化与良性比较,差异有统计学意义（P〈0.05）,以结节内部钙化和结节边界不清为诊断标准,以术后病理诊断为金标准,判断结节为恶性的灵敏度为51%（95%CI 38%-67%）,特异度为89%（95%CI 76%-94%）,阳性似然比为3.2（95%CI 2.5-3.8）,诊断试验的受试者工作特征曲线下面积为0.71。结论边界不清且存在内部钙化的甲状腺结节的恶性程度显著增加,综合分析甲状腺结节的超声特点,可提高诊断准确率。

Objective To investigate the diagnostic value of color Doppler ultrasonography on benign thyroid nodes. Method From Jun. 2009 to Aug. 2013 in Shanghai Tenth People＇ s Hospital,a total of 78 patients with 178 thyroid nodes were finally included in this study,among the 178 thyroid nodes,71 were malignancy and 107 were benign. The ultrasound characteristics of benign and malignant thyroid nodules were analyzed. Results The node border,node nature,echo property and node calcification of malignant nodes were significantly different from benign nodes（ P〈0. 05）. Setting internal calcified nodules and unclear of nodule boundary as the diagnostic criteria,and the pathological diagnosis as the gold standard,the diagnosis sensitivity and specificity of malignancy were 51%（ 95% CI 38%-67%） and 89%（ 95% CI 76%-94%）respectively,the positive likelihood ratio was 3. 2（ 95% CI 2. 5-3. 8） and the area under the ROC was 0. 71.Conclusion Nodes with unclear border and calcification indicate significantly increased malignancy. The comprehensive analysis of thyroid node＇s ultrasonic features can significantly increase the diagnosis accuracy.