高频彩色多普勒超声对甲状腺乳头状癌的诊断价值

Diagnostic value of high frequency color doppler ultrasound in thyroid papillary carcinoma

目的探讨高频彩色多普勒超声对甲状腺乳头状癌(PTC)的鉴别诊断价值。方法回顾性分析2016年5月至2018年10月期间安徽中医药大学第一附属医院经手术病理证实的33例PTC及40例甲状腺良性结节的高频彩色多普勒超声声像图表现,记录结节是否为低回声、纵横比是否≥1、内部回声是否均匀、有无微钙化、边界是否规则、境界是否清晰、血流是否丰富,并对上述超声征象作统计学处理,寻找诊断PTC的较敏感征象。结果通过χ^2检验进行单因素分析发现:低回声、纵横比、微钙化、边缘不规则均是影响PTC诊断的因素(χ^2=19.513、23.631、39.603、18.583,均P<0.001)。通过logistic回归进行多因素分析发现:低回声(OR=22.363,95%CI:1.914~258.991)、纵横比(OR=11.358,95%CI:1.513~85.292)、微钙化(OR=77.469,95%CI:5.289~1134.637)是预测PTC的敏感指标;其中微钙化是最为敏感的指标,对应的灵敏度为72.7%,特异度为97.5%。结论高频彩色多普勒超声检查在PTC鉴别诊断中具有较高的临床应用价值,其中微钙化指标最为敏感。

Objective To investigate the diagnostic value of high frequency color Doppler ultrasound in papillary thyroid carcinoma(PTC).Methods The ultrasonographic features of 33 cases of PTC and 40 cases of benign thyroid nodules confirmed by operation and pathology in The First Affiliated Hospital of Anhui Traditional Chinese Medical University from May 2016 to October 2018 were retrospectively analyzed.The following ultrasonographic signs were recorded and processed statistically to identify sensitive signs of PTC:whether the nodules were hypoechoic,whether the aspect ratio was≥1,whether the internal echo was uniform,wheth⁃er there was microcalcification,whether the boundary was regular,whether the boundary was clear and whether the blood flow was rich.Results The single factor analysis by χ^2 test showed that low echo,taller than wide shape,microcalcification and irregular margin were all factors influencing the diagnosis of PTC(χ^2=19.513,23.631,39.603 and 18.583,respectively,all P<0.001).Logis⁃tic regression analysis showed that low echo(OR=22.363,95%CI:1.914⁃258.991),taller than wide shape(OR=11.358,95%CI:1.513⁃85.292)and microcalcification(OR=77.469,95%CI:5.289⁃1134.637)were sensitive indicators for predicting PTC,and mi⁃crocalcification was the most sensitive indicator with sensitivity of 72.7%and specificity of 97.5%.Conclusion High frequency color Doppler ultrasonography is of high clinical value in the diagnosis of PTC,and microcalcification is the most sensitive index.