二维超声与高频超声对良恶性甲状腺结节的诊断价值比较

Comparison of diagnostic value of two-dimensional ultrasound and high frequency ultrasound in benign and malignant thyroid nodules

目的比较二维超声与高频超声对良恶性甲状腺结节的诊断价值。方法选择2020年10月至2021年10月于杨凌示范区医院体检中心超声科接受检查的80例甲状腺结节(单发结节)患者作为研究对象,依据手术病理检查结果将其分为恶性组(n=50)及良性组(n=30)。所有患者均给予病理、二维超声与高频超声检查。统计两组的病理检查结果;以病理检查结果为金标准,比较两种检查方法对恶性甲状腺结节的诊断效能;比较两种检查方法的超声特征。结果病理检查结果显示,良性组甲状腺囊肿6例,滤泡囊肿4例,囊腺瘤11例,结节性甲状腺肿9例;恶性组微小乳头状癌12例,滤泡性癌11例,乳头状癌27例。高频超声诊断恶性甲状腺结节的特异度及准确度高于二维超声,差异具有统计学意义(P<0.05)。恶性组的内部低回声、纵横比≥1、有微钙化占比高于良性组,差异具有统计学意义(P<0.05);两组的形态、边界、血流分级情况比较,差异无统计学意义(P>0.05)。结论高频超声对良恶性甲状腺结节的诊断效能较高,临床上可通过比较结节内部回声、纵横比及钙化情况等辅助鉴别结节性质。

Objective To compare the diagnostic value of two-dimensional ultrasound and high frequency ultrasound in benign and malignant thyroid nodules.Methods A total of 80 patients with thyroid nodules(single nodules)who were examined in the ultrasound department of the physical examination center of Yangling Demonstration Zone Hospital from October 2020 to October 2021 were selected as the research objects.According to the results of surgical pathological examination,the patients were divided into malignant group(n=50)and benign group(n=30).All patients were examined by pathology,two-dimensional ultrasound and high frequency ultrasound.The pathological examination results of the two groups were counted;the results of pathological examination were used as the gold standard,the diagnostic efficacy of the two methods for malignant thyroid nodule were compared;the ultrasonic features of the two examination methods were compared.Results The results of pathological examination showed that there were 6 cases of thyroid cyst,4 cases of follicular cyst,11 cases of cystadenoma and 9 cases of nodular goiter in the benign group;there were 12 cases of micropapillary carcinoma,11 cases of follicular carcinoma and 27 cases of papillary carcinoma in the malignant group.The specificity and accuracy of high frequency ultrasound in the diagnosis of malignant thyroid nodule were higher than those of two-dimensional ultrasound,and the differences were statistically significant(P<0.05).The proportions of internal low echo,aspect ratio≥1 and microcalcification in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05);there were no significant differences in the morphology,boundary and blood flow classification between the two groups(P>0.05).Conclusion High frequency ultrasound has a high diagnostic efficiency for benign and malignant thyroid nodules.Clinically,the nature of nodules can be identified by comparing the internal echo,aspect ratio and calcification of nodules.