不同性质甲状腺结节的临床特征与高频超声诊断价值分析

Clinical features of thyroid nodules of different properties and diagnostic value of high-frequency ultrasound

目的:探讨高频超声在不同性质甲状腺结节诊断中的应用价值及临床特征分析。方法:选取石河子市人民医院2021年1月—2022年10月收治的110例甲状腺结节患者,共有甲状腺结节162枚,其中良性结节104枚,恶性结节58枚。对比不同性质甲状腺结节临床特征及高频超声声像图表现差异。结果:高频超声诊断甲状腺恶性结节的灵敏度为98.17%,特异度为97.12%,准确率为97.53%。高频超声检查结果显示,甲状腺良性结节大多为多发结节,结节形态规则,边界清晰,超声显示呈点状、片状、弧状或不规则的强回声光团,少部分结节出现粗大胶质钙化;甲状腺恶性结节多为单发结节,结节形态不规则,边界模糊、大多为锯齿状或蟹足状,超声表现为不均质低回声,大部分结节出现微小钙化或砂砾样钙化,且内部血流紊乱。良、恶性甲状腺结节患者在结节数目、结节形态、结节边界、内部回声、微钙化、声晕、纵横比、血流信号、血流模式方面比较,差异有统计学意义(P<0.05)。高频超声检查中恶性结节患者的高频超声检查中恶性结节患者舒张期最低血流速度(D)(4.20±0.72)、阻力指数(resistance index,RI)(0.79±0.22)及搏动指数(perfusion index,PI)(1.41±0.42)均高于良性结节的(2.84±0.41)cm/s、(0.64±0.21)、(0.91±0.24),差异有统计学意义(P<0.05)。结论:高频超声在不同性质甲状腺结节鉴别诊断中的应用效果较好,值得临床应用。

Objective To explore the application value and clinical characteristics of high-frequency ultrasound in the diagnosis of thyroid nodules with different properties.Methods A total of 110 patients with thyroid nodules admitted to Shihezi People's Hospital from January 2021 to October 2022 were selected as the research subjects.There were 162 thyroid nodules in 110 patients with thyroid nodules,including 104 benign nodules and 58 malignant nodules.The clinical features of thyroid nodules of different properties and the differences in high-frequency ultrasound sonogram were compared.Results The sensitivity,specificity and accuracy of high-frequency ultrasound in the diagnosis of thyroid nodule were 98.17%,97.12%and 97.53%.The results of highfrequency ultrasonography showed that most benign thyroid nodules were multiple nodules with regular shape and clear boundaries.The ultrasonography showed spot-shaped,flaky-shaped,arc-shaped or irregular strong echoic light clusters,and a few nodules showed coarse glial calcification.Most malignant thyroid nodules were single nodules with irregular shape,blurred boundaries,mostly serrated or crab feet,uneven hypoechoic ultrasonography,minor calcification or gritty-like calcification in most nodules,and internal blood flow disorders.There were statistically significant differences in nodule number,nodule shape,nodule boundary,internal echo,microcalcification,sound halo,aspect ratio,blood flow signal and blood flow pattern between benign and malignant thyroid nodules(P<0.05).In high-frequency ultrasound examination of patients with malignant nodules,patients with malignant nodules had the lowest diastolic blood flow velocity(D)(4.20±0.72),resistance index(RI)(0.79±0.22),and perfusion index(PI)(1.41±0.42)were higher than benign nodules[(2.84±0.41)cm/s,(0.64±0.21),(0.91±0.24)],the difference was statistically significant(P<0.05).Conclusion The application effect of high-frequency ultrasound in the differential diagnosis of thyroid nodules of different properties is good,and it is worthy of clinical popularization.