超声检查对甲状腺微小乳头状癌、微小结节性甲状腺肿的诊断价值

Diagnostic value of ultrasonography in papillary thyroid microcarcinoma and micronodular goiter

目的 探讨超声检查对甲状腺微小乳头状癌(PTMC)、微小结节性甲状腺肿(MNG)的诊断价值。方法选取184例甲状腺微小结节患者,均接受超声检查,以病理检查结果为金标准,评估超声检查对PTMC、MNG的诊断效能,比较PTMC与MNG患者的超声征象。结果 病理检查结果显示,PTMC患者95例,MNG患者89例。超声检查诊断PTMC的灵敏度为96.84%,特异度为82.02%,准确度为89.67%,超声检查诊断PTMC、MNG的结果与病理检查结果的一致性均较好(Kappa=0.792、0.751,P﹤0.01)。PTMC与MNG患者结节数目、形态、边界、回声情况、钙化情况、纵横比比较,差异均有统计学意义(P﹤0.01)。PTMC患者共检出135个结节,结节多为单发、形态不规则、边界模糊、病灶内部低回声、微钙化;MNG患者共检出152个结节,结节多为多发、形态规则、边界清晰、病灶内部高回声、边缘钙化。结论 超声检查对PTMC、MNG的诊断价值较高,二者的超声征象存在一定的差异,超声检查可为二者早期诊断、治疗方案的选择提供参考。

Objective To investigate the diagnostic value of ultrasonography in papillary thyroid microcarcinoma(PTMC) and micronodular goiter(MNG). Method A total of 184 patients with thyroid micronodules were selected and all received ultrasonography. Using pathological examination results as the gold standard, the diagnostic efficacy of ultrasonography in PTMC and MNG was evaluated, and the ultrasound features of PTMC and MNG patients were compared.Result Pathological examination results showed that 95 patients were PTMC and 89 patients were MNG. Ultrasonography had a sensitivity of 96.84%, a specificity of 82.02%, and an accuracy of 89.67% for the diagnosis of PTMC. The results of ultrasonography in the diagnosis of PTMC and MNG were in good agreement with the results of pathological examinations(Kappa=0.792, 0.751, P<0.01). The number, shape, border, echo, calcification and aspect ratio of nodules between PTMC and MNG patients were significantly different(P<0.01). A total of 135 nodules were detected in PTMC patients, most of the nodules were single, irregular in shape, blurred in boundary, hypoechoic and microcalcification in the lesion. A total of 152 nodules were detected in MNG patients, most of the nodules were multiple, regular in shape, clear in boundary, hyperechoic in the lesions, and calcified at the edges. Conclusion Ultrasonography has a high diagnostic value for PTMC and MNG, and there are certain differences in the ultrasonic signs of the two. Ultrasonography can provide a reference for the early diagnosis and treatment plan selection of the two.