甲状腺结节患者的临床病理性质与超声结果分析

Clinical pathological characteristics and ultrasonic findings in patients with thyroid nodules

目的探讨甲状腺结节患者病理性质的超声相关影响因素及对良恶性的鉴别诊断价值。方法选取2016年1月至2017年1月间武汉科技大学附属武汉市汉阳医院收治的80例甲状腺结节患者,均行超声检查及弹性成像检查,比较超声各相关影响因素在甲状腺结节病理性质上的鉴别价值。结果结节性甲状腺肿及甲状腺腺瘤的超声弹性成像评分均为2分,甲状腺乳头状癌的超声弹性评分为4分。单因素分析显示,结节性质、年龄、回声性质、形态、边界、弹性评分、纵横比及有无微钙化,与甲状腺结节病理性质相关,差异有统计学意义(P<0.05)。多因素分析显示,弹性评分≥3级、形态不规则、年龄≥45岁、有微钙化及结节性质为实性,为甲状腺结节病理性质为恶性的危险因素,差异有统计学意义(P<0.05)。弹性评分的OR值最高。结论弹性评分≥3级、形态不规则、年龄≥45岁、有微钙化和结节性质为实性,是甲状腺结节病理性质为恶性的危险因素。

Objective To determine the factors influencing pathological character and the diagnostic value of ultrasonography in distinguishing the benign from the malignant thyroid nodules. Methods Eighty patients with thyroid nodules treated at Hanyang Hospital Affiliated to Wuhan University of Science and Technology from January 2016 to January 2017 were selected. All patients underwent ultrasound and elastography examination. The differential diagnostic value of ultrasonographic characteristics in distinguishing the benign from the malignant thyroid nodules was compared. Results The ultrasound elastography score was 2 points for both thyroid cancer and thyroid adenoma were and 4 points for papillary thyroid cancer. Univariate analysis showed that the nature,age,echo characteristics,morphology,boundary,elastic score,aspect ratio and micro calcification were correlated with the pathological characteristics of thyroid nodules（ P〈0. 05）. Multivariate analysis showed that the ultrasound elastography score≥grade 3,irregular shape,≥45 years old,micro calcification nodules and solid thyroid nodules were risk factors of malignant thyroid nodule pathology（ P〈0. 05）,in which OR was the highest for the elastic score. Conclusion The ultrasound elastography score≥grade 3,irregular shape,≥45 years old,micro calcification nodules and solid thyroid nodules are the risk factors of malignant thyroid nodule pathology.