超声测量纵横比在不同大小甲状腺微小癌诊断中的应用价值

Taller-than-wide sign in diagnosing thyroid microcarcinoma using ultrasound

目的:探讨超声测量纵横比在最大切面直径≤10 mm的甲状腺结节良恶性鉴别诊断中的应用价值。方法:对208例患者的232个甲状腺结节进行回顾性病理对照研究,观察并记录结节的个数,测量各个结节最大切面上的纵径与横径,得到纵横比;以病理诊断为金标准,探讨纵横比≥1对甲状腺微小癌的诊断价值。结果:纵横比≥1对不同大小甲状腺微小癌的诊断价值有显著差异。随着体积的增加,甲状腺微小癌的检出率也随之提高。在最大切面直径≤4 mm的纵横比≥1的甲状腺结节中,以良性结节居多;而在最大切面直径>4mm的纵横比≥1的甲状腺结节中,微小癌所占比例显著上升。结论:纵横比≥1对不同大小甲状腺微小癌的诊断意义不同,正确辨别其特性有助于鉴别甲状腺结节的良恶性,提高甲状腺恶性结节的诊断效率,避免良性结节的过度诊疗。

Objective： To investigate the clinical value of ＂taller-than-wide sign＂ on ultrasound image in diagnosing thyroid nodules which diameter is 10 mm or less.Methods： The data of 208 patients with 232 thyroid nodules were retrospectively analyzed. The number of nodules and anteroposterior/ transverse diameter ratio were recorded. Taking the pathological results as gold standard, the application value of taller-than-wide sign in differentiating benign and malignant thyroid nodules which diameter was 10 mm or less was assessed.Methods： The data of 208 patients with 232 thyroid nodules were retrospectively analyzed. The number of nodules and anteroposterior/ transverse diameter ratio were recorded. Taking the pathological results as gold standard, the application value of taller-than-wide sign in differentiating benign and malignant thyroid nodules which diameter was 10 mm or less was assessed.Results： There were significant differences in the aspect of taller-than- wide sign （anteroposterior/transverse diameter ratio ≥1） among thyroid nodules with different sizes. With the increase in volume, the detection rate of thyroid microcarcinoma was also increased. Benign thyroid nodules took a large proportion of thyroid nodules which diameter was 4 mm or less with taller-than-wide sign, while the proportion of thyroid microcarcinoma was increased significantly in thyroid nodules which diameter was larger than 4 mm with taller-than-wide sign.Conclusion： Taller-than-wide sign can help to identify benign and malignant thyroid nodules which diameter is 10 mm or less.