超声检查对甲状腺弥漫性病变合并结节的声像特征分析

Ultrasonographic characteristics of thyroid diffuse lesions with nodules

目的探讨超声检查鉴别诊断甲状腺弥漫性病变合并甲状腺良恶性结节的声像特征及临床价值。方法回顾性分析2015年1月至2015年12月收集的139例甲状腺弥漫性病变合并甲状腺结节患者的超声资料,所有患者经过穿刺活检或术后病理结果予以证实,对比良恶性结节的超声声像特征及超声的鉴别诊断价值。统计分析采用SAS10.0软件,良恶性结节的声像特征对比采用χ2检验;P值<0.05说明差异具有统计学意义。结果共检出147个甲状腺结节,其中良性52个(35.37%)、恶性95个(64.63%);恶性结节的不均质回声率、边界不清楚率、点状钙化灶发生率、Ⅲ级血流分布率、阻力指数≥0.7患者所占比率均显著的高于良性结节患者,差异具有统计学意义(P<0.05);超声鉴别诊断甲状腺良恶性结节的灵敏度为70.53%、特异度为78.85%、漏诊率为29.47%、误诊率为21.15%。结论根据声像特征进行鉴别诊断甲状腺弥漫性病变合并甲状腺良恶性结节具有一定的临床价值,同时具有无创、方便的优势。

Objective To summarize ultrasonographic characteristics of benign and malignant nodules in thyroid diffuse lesions and to investigate its clinical value in differential diagnosis.Methods Ultrasound data of 139 patients with diffuse thyroid disease and thyroid nodules from January 2015 to December 2015 were analyzed retrospectively.All the patients＇ diagnosis were confirmed by biopsy or postoperative pathological results,then clinical value of ultrasound in the differential diagnosis were also evaluated.Statistical analysis were performed by using SAS10.0 software.Comparison of ultrasonographic characteristics of benign and malignant nodules was performed by using x2 test.A P value 〈0.05 was considered as statistically significant difference.Results Among 147 thyroid nodules,there were 52 benign nodules（35.37%）,95 malignant nodules（64.63%）.Compared with benign nodules,malignant nodules showed higher rate of inhomogeneous echo,unclear boundary,calcification,grade Ⅲ blood flow distribution and higher composition ratio of resistance index of ≥0.7.with significant difference（P〈0.05）.In differential diagnosis of benign and malignant thyroid nodules,the sensitivity of ultrasound was 70.53%,the specificity was 78.85%,the missed diagnosis rate was 29.47%,the misdiagnosis rate was 21.15%.Conclusion Application of ultrasonography in differential diagnosis of benign and malignant nodules in thyroid diffuse lesions has clinical value,with advantages of non-invasive and convenient.