超声随访在甲状腺良恶性结节鉴别诊断中的价值探讨

The value of ultrasonic follow-up in diagnosis of benign and malignant thyroid nodules

目的分析甲状腺良恶性结节在随访过程中的生长变化，提高其超声诊断准确率。方法回顾性分析经病理证实的161个甲状腺良恶性结节的超声随访征象资料，包括结节大小、内部成分、回声、边缘、微钙化、纵横比及其与被膜关系、引流区淋巴结的变化。结果甲状腺良性结节93个，恶性结节68个，二者在结节大小、内部成分、微钙化及与被膜关系、引流区淋巴结方面的变化差异均有统计学意义（P〈0．05），在回声、边缘、纵横比变化方面差异均无统计学意义（P〉0．05）；良性结节较恶性结节易出现结节大小、内部成分的变化，恶性结节较易出现微钙化，结节突破被膜、淋巴结转移提示恶性。结论分析甲状腺结节在超声随访中的相关征象变化有利于结节良恶性的鉴别。

Objective To analyze the changes of benign and malignant thyroid nodules during follow up and to increase the diagnostic accuracy. Methods The ultrasonographic changes of 161 thyroid nodules confirmed by pathology were retrospectively analyzed, including size, internal components, echogenicity, margin, microcalcification, anteroposterior to transverse dimension ratio（A/T） and the relationships with thyroid capsule, and the change of cervical lymph nodes. Results Ninety-three benign thyroid nodules and 68 malignant thyroid nodules were enrolled in this study, the changes in size, internal components, microcalcification, the relationships with glandular capsule, and cervical lymph nodes were significantly different（ P 〈 0.05）, while the echogenicity, margin, and A/T were not significantly different, benign nodules changed more easily in size and internal components, while malignant nodules changed more easily in microcalcification. Both the nodules broken the thyroid capsule or cervical lymph nodes exhibited malignant signs suggest probable malignancy. Conclusions Analyzing the ultrasonographic changes during follow-up contributes to identify benign and malignant thyroid nodules.