甲状腺部分囊性结节超声特征及其对良恶性的鉴别诊断效果

Using ultrasonography to evaluate the ultrasound characteristics of the benign and malignant partially cystic thyroid nodules

目的探讨部分甲状腺囊性结节超声特征对占位性病变良恶性的鉴别诊断效果。方法使用超声对128例经术后病理证实的部分甲状腺囊性结节患者进行诊断,与术后病理对比,观察超声特征。结果 128例患者中,102例良性,26例恶性。超声诊断的灵敏度、特异度、准确度分别为92.31%、98.03%、96.88%。纵横比大于1、边界毛刺或微小分叶与结节恶性有关(P<0.05),海绵状结构和边界光滑与结节良性有关(P<0.05),结节数目与良恶性无关(P>0.05)。对于结节内部实性部分,内部实性偏心锐角、微钙化、低回声及极低回声与结节恶性有关(P<0.05)。Logistic回归分析显示极低回声、低回声、纵横比、微钙化和内部实性偏心锐角是预测结节恶性的重要因素。结论超声诊断的声像特征可用于鉴别诊断占位性病变中的部分甲状腺囊性结节。

Objective To evaluate the value of sonographic characteristics of partially cystic thyroid nodules and the efficacy of diagnosis of lesions. Methods A total of 128 patients were undergoing preoperative conventional ultrasound diagnosis, and were compared with the postoperative pathological diagnosis to evaluate the efficacy. The ultrasound characteristics were observed and their significance in differential diagnosis was analyzed. Results In the 128 cases, 26 cases were malignant and 102 cases were benign lesions. Compared with postoperative pathological diagnosis, the sensitivity was 92.31%, specificity was 98.03%, and accuracy rate was 96.88%by ultrasound. The aspect ratio greater than 1, speculated or micro-lobulated margin were significantly associated with malignant （P〈0.05）;while spongiosis and smooth margin were significantly associated with benign （P〈0.05）. The number of nodule was insignificantly associated with benign or malignant （P〉0.05）. For the internal solid portion of the nodule, acute angle eccentric structure, micro-calcification, hypoechogenecity, and marked hypoechogenecity were significantly associated with malignant （P〈0.05）. The Logistic regression analysis showed that hypoechogenecity, marked hypoechogenecity, aspect ratio, acute angle eccentric structure, and micro-calcification were import predictive factors of malignant lesions. Conclusion Sonographic characteristics can be used to diagnose the benign and malignant partially cystic thyroid nodules.