超声下钙化特征对甲状腺良恶性结节的诊断价值分析

The diagnostic value of ultrasonographic calcification on benign and malignant thyroid nodules

目的分析超声下钙化特征对甲状腺良恶性结节的诊断价值。方法回顾性分析2015年1月~2017年6月我院经超声检查并手术或穿刺活检病理确诊的133例甲状腺结节患者的临床资料。比较甲状腺结节钙化灶的特点与结节良恶性的相关性。结果本研究133例患者超声发现176个甲状腺结节,其中含钙化灶的结节71个(40.34%)、无钙化灶的结节105个(59.66%)。经病理学诊断共发现112个良性结节(63.64%)、64个恶性结节(36.36%)。钙化的甲状腺结节中恶性结节发生率(77.46%)显著高于无钙化甲状腺结节中恶性结节发生率(7.62%),差异具有统计学意义(P<0.05)。38个含微钙化型钙化灶的结节中,恶性结节发生率为94.74%(36/38);23个含粗钙化型钙化灶的结节中恶性结节发生率为47.83%(11/23),二者相比差异具有统计学意义(P<0.05)。恶性甲状腺结节钙化发生率为87.50%(56/64),显著高于良性甲状腺结节中钙化发生率(13.39%,15/112)(P<0.05)。结论超声下钙化特征对甲状腺结节良恶性的诊断具有重要价值,尤其是微钙化型钙化灶可作为筛查恶性甲状腺结节的特异性指标之一,值得临床推广。

Objective To analyze the diagnostic value of ultrasonographic calcification on benign and malignant thyroid nodules. Methods The clinical data of 133 thyroid nodules diagnosed in our hospital from January 2015 to June 2017 by ultrasound examination and surgical or biopsy were retrospectively analyzed. Compared the correlation between the characteristics of calcified foci of thyroid nodules and benign and malignant nodules. Results In 133 patients, 176 thyroid nodules were found by ultrasound, including 71（40.34%） nodules with calcification and 105（59.66%） nodules without calcification. A total of 112 benign nodules（63.64%） and 64 malignant nodules（36.36%） were found by pathological diagnosis. The incidence of malignant nodules in calcified thyroid nodules（77.46%） was significantly higher than that in no-calcified thyroid nodules（7.62%）, and the difference was statistically significant（P〈0.05）. Among 38 nodules with calcified calcification, the incidence of malignant nodules was 94.74%（36/38）; the incidence of malignant nodules in 23 nodules with calcified calcification was 47.83%（11/23） There was a statistically significant difference between the two groups（P〈0.05）. The incidence of calcification in malignant thyroid nodules was 87.50%（56/64） significantly higher than that in benign thyroid nodules（13.39%, 15/112）（P〈0.05）. Conclusion The characteristics of calcification under ultrasonography are of great value in the diagnosis of benign and malignant thyroid nodules. In particular, microcalcification calcification can be used as one of the specific indicators of screening for malignant thyroid nodules. It is worthy of clinical promotion.