超声检查对甲状腺弥漫性病变合并结节的诊断有效性研究

Effectiveness of ultrasonography in diagnosing diffuse thyroid disease with nodules

目的探讨超声检查对甲状腺弥漫性病变合并结节的诊断价值。方法以开封市通许县中医院2019年3月至2021年8月期间收治的75例甲状腺弥漫性病变合并结节患者作为研究对象,均接受超声检查。以手术病理活检结果为金标准,分析超声检查对甲状腺弥漫性病变合并结节的诊断价值以及超声对该疾病声像特征的检出情况。结果75例甲状腺弥漫性病变合并结节患者在手术病理活检中共检出88个结节,其中恶性结节65个(87%),良性结节23个(13%);其中良性结节中桥本甲状腺炎10个(43%),滤泡型腺瘤2个(9%),结节性甲状腺炎7个(30%),肉芽肿2个(9%),甲状腺腺瘤1个(4%),亚急性甲状腺炎1个(4%);恶性结节中乳头状癌59个(91%),滤泡状癌5个(8%)腺样囊腺癌1个(2%)(P<0.05);甲状腺超声检测出良性结节15个(17%),恶性结节47个(53%),诊断符合率为65%,特异度为72%,敏感度为65%;超声检查中良性低回声、边界不清楚、形态不规则、有钙化灶、血流分级、阻力指数和恶性结节对比差异均具有统计学意义(P<0.05)。结论超声检查对甲状腺弥漫性病变合并结节的诊断具有一定的诊断价值。

Objective To explore the diagnostic value of ultrasonography for diffuse thyroid lesions with nodules.Methods Seventy-five patients with diffuse thyroid lesions and nodules who were admitted to our ho-spital from March 2019 to August 2021 were selected as the research objects,and all of them underwent an ultr-asound examination.Considering the results of surgical pathological biopsy as the gold standard,the diagnostic value of ultrasonography for the diagnosis of diffuse thyroid lesions with nodules and the detection of ultrasound features of the disease were analyzed.Results In the 75 patients with diffuse thyroid lesions and nodules,88 nodules were detected in surgical pathological biopsy.Of these 88 nodules,of which 65 were malignant nodules(87%)and 23 were benign nodules(13%);among them,the benign nodules were bridged in bridge.There were 10 cases of thyroiditis(43%),2 cases of follicular adenoma(9%),7 cases of nodular thyroiditis(30%),2 cases of granuloma(9%),and 1 case of thyroid adenoma(4%),and 1 case of subacute thyroiditis(4%);in the malignant nodules,there were 59 cases of(91%)papillary carcinomas in malignant nodules(91%),5 cases of(8%)follicular carcinomas(8%),and 1 case of adenoid cystadenocarcinoma(1%)(P<0.05).The thyroid ultrasound detected 15 benign nodules(17%)and,47 malignant nodules(53%).The diagnostic coincidence rate was 65%,the specificity was 72%,and the sensitivity was 65%;The differences between benign hypoechoic,unclear boundary,irregular shape,calcification,blood flow grade,resistance index,and malignant nodules in the ultrasound examination wereas statistically signifi-cant(P<0.05).Conclusion Ultrasonography has certain diagnostic value in the diagnosis of diffuse thyroid lesions with nodules.