纵横比值鉴别甲状腺微小结节良恶性的应用研究

Diagnostic value of taller-than-wide shape on thyroid micronodules

目的探讨不同切面纵横比值(A/T)在甲状腺微小结节良恶性鉴别中的诊断价值。方法选取我院经手术病理证实的258例甲状腺微小结节患者,共426个结节,其中良性236个,恶性190个。比较纵、横断面A/T≥1诊断甲状腺微小结节良恶性的差异。绘制纵、横断面A/T≥1诊断甲状腺微小癌的受试者工作特性曲线,计算曲线下面积。结果甲状腺微小癌纵、横断面A/T≥1所占比例均大于良性结节,差异均有统计学意义(均P=0.000)。纵、横断面A/T≥1诊断甲状腺微小癌的敏感性、特异性、准确率分别为72.6%、84.7%、79.3%和77.9%、83.1%、80.8%。结论横断面A/T≥1诊断甲状腺微小癌的敏感性高于纵断面,但特异性略低于纵断面。二者联合诊断可提高甲状腺微小癌的超声诊断准确性。

Objective To explore the diagnostic value of ＂taller-than-wide sign＂of thyroid micronodules in different planes on the benign and malignant thyroid micronodules. Methods A total of 426 small thyroid nodules with 258 cases which pathologically confirmed were included in this study. The ＂taller-than-wide sign＂of each nodules in transverse and longitudinal plane were calculated,and the differences between ＂taller-than-wide sign＂in transverse and longitudinal plane were compared.The characteristic curve of transverse and longitudinal plane was drawed. The area under the curve was calculated. Results The constituent ratio of ＂taller-than-wide sign＂between benign and malignant thyroid micronodules was significantly different（P=0.000）.The sensitivity,specificity and accuracy of ＂taller-than-wide sign＂in longitudinal plane and the transverse plane were 72.6%,84.7%,79.3% and 77.9%,83.1%,80.8%. Conclusion The sensitivity of ＂taller-than-wide sign＂ in transverse plane is higher than longitudinal plane,but the specificity is less than longitudinal plane. So we should combine the transverse and longitudinal plane to improve the detection rate of thyroid microcarcinoma.