超声定量评价甲状腺结节包膜反应

Ultrasonographic quantitative evaluation of thyroid nodule capsular reaction

目的探讨超声定量评价甲状腺结节与包膜的关系对于术前评估甲状腺结节良恶性的价值。方法回顾性分析79例经病理证实的、位于甲状腺包膜下肿瘤,分析其与包膜的关系,通过测量结节纵径(自结节包膜交界处至结节最深处,V)及结节凸出甲状腺包膜与突出最高处的距离(L),评价L/V诊断甲状腺恶性结节的效能。结果甲状腺良性和恶性结节平均L/V值分别为0.241±0.041、0.162±0.054,差异有统计学意义(t=-7.367,P<0.01)。L/V诊断甲状腺良恶性结节的ROC曲线下面积为0.87(P<0.01)。L/V=0.225时,诊断甲状腺恶性结节的敏感度为82.17%、特异度为87.53%;L/V=0.245时,诊断甲状腺恶性结节的敏感度为67.10%,特异度为95.12%。结论超声可清晰显示甲状腺结节与包膜的关系,通过测量L/V可鉴别诊断甲状腺结节的良恶性。

Objective To quantitatively observe the value of relationship between nodule and corresponding capsular with ultrasonography in assessment of malignant and benign thyroid nodules. Methods A total of 79 cases with subcapsular tumors of thyroid gland confirmed pathologically were analyzed retrospectively, and the relationship between tumors and capsule was analyzed. Longitudinal diameter of nodules （from the junction of nodule and capsule to the deepest of nodule, V） and distance from nodule protruding thyroid capsule to the highest point of nodule （L） were measured, and L/V was evaluated. Diagnostic efficiency of L/V in diagnosis of malignant thyroid nodule was evaluated. Results The average L/V of benign and malignant nodules was 0.241±0.041 and 0.162±0.054, respectively （t=-7.367, P〈0.01）. The area under ROC curve of L/V in diagnosis of benign and malignant thyroid nodules was 0.87 （P〈0.01）. When L/V=0.225, the sensitivity was 82.17%, and the specificity was 87.53%; when L/V=0.245, the sensitivity was 67.10%, and the specificity was 95.12%. Conclusion Ultrasonography can clearly show the relationship between thyroid nodules and capsule, and L/V can be used for differential diagnosis of benign and malignant thyroid nodules.