甲状腺结节内钙化的三维超声特征在结节定性中的价值

The differential diagnostic value of three-dimensional ultrasonography feature about calcification in thyroid nodule

目的探讨甲状腺结节内钙化的三维超声特征在鉴别甲状腺结节性质中的价值。方法选取98例甲状腺结节患者(133个结节)行三维超声检查,术前均检出结节内伴有钙化,获得甲状腺结节内钙化的以下三维特征:结节内钙化数目、钙化的最大径、单位容积内钙化数以及钙化的分布、形态类型,按病理结果分为良性结节和恶性结节,比较良、恶性甲状腺结节的三维超声特征的差异。结果 133个甲状腺结节中,恶性结节47个,良性结节86个。良、恶性甲状腺结节内钙化数目的差异无统计学意义,良、恶性甲状腺结节内单位容积内平均钙化数和钙化最大径差异有统计学意义(P<0.05),恶性甲状腺结节单位容积内平均钙化数目明显高于良性甲状腺结节(P<0.05),而恶性甲状腺结节组钙化最大径小于良性甲状腺结节。良、恶性甲状腺结节钙化的分布类型差异有统计学意义(P<0.05),周边型的结节中良性结节病所占比例为91%(51/56),中央型中恶性结节病所占比例为86.1%(25/29)。良、恶性甲状腺结节钙化形态类型的差异有统计学意义(P<0.05),良、恶性甲状腺结节均以I型钙化所占比例最高,恶性甲状腺结节中I型钙化发生率[85.1%(40/47)]显高于良性甲状腺结节[47.7%(41/86)](P<0.05)。结论甲状腺结节内钙化的不同三维特征在甲状腺结节的良恶性鉴别诊断中具有一定的价值。

Objective To evaluate the differential diagnostic value of three-dimensional ultrasonography feature about calcification in thyroid nodule.Methods 98 patients with thyroid nodule（133 nodules）were examined with three-dimensional ultrasonography to assess the characters of calcification in thyroid nodules.The results were compared with post-operative pathological results.The three-dimensional ultrasonography features were as follows：the number of calcification in the nodule,the maximum diameter of calcification,average number of calcification in unit volume,and the distribution,morphological types of calcification.Nodules were divided into benign and malignant according to the pathological result,and the characteristics of these nodules were compared.Results According to this data,133 thyroid nodules,47 nodules were malignant,86 nodules were benign.There was no significant difference in the number of calcifications in benign and malignant thyroid nodules.The difference about the maximum diameter of calcification and the average number of calcification in unit volume was statistically significant in benign and malignant thyroid nodules.And the average number of calcification in unit volume in malignant nodules was obviously higher than that in benign nodules,and the maximum diameter of calcification in malignant nodules was less than it in the benign nodules.As the distribution types,the differences between benign and malignant thyroid nodules were statistically significant（P〈0.05）.The proportion of benign nodules in marginal calcification type was 91%（51/56）,and the proportion of maglinant nodules in central calcification type was 86.1%（25/29）.As the morphological type,the differences between benign and malignant thyroid nodules was statistically significant（P〈0.05）.The proportion of type I were the highest in two groups.The incidence of type I in malignant nodules was 85.1%（40/47）,which were significantly higher than that in benign nodules 47.7%（41/86）.Conclusion The three-dimensional ultrasonography features of calcification in thyroid nodules is proved to be helpful for differential diagnosing thyroid nodules.