彩色多普勒超声在甲状腺结节性质诊断及鉴别诊断中的临床应用价值

Clinical Application Value of Color Doppler Ultrasonography in the Characteristic Diagnosis and Differential Diagnosis of Thyroid Nodule

目的:研究彩色多普勒超声在甲状腺结节性质诊断和鉴别诊断中的应用价值。方法:将2022年3月~2023年1月来本院开展甲状腺检查的651例患者作为研究对象,入院后对所有调查对象均实施彩色多普勒超声检查,并对研究对象实施病理活检,以病理活检所得的结果作为金标准,判断彩色多普勒超声在甲状腺结节性质和鉴别诊断中的作用。结果:(1)病理活检检出恶性85例,占13.06%,其余566例为良性结节,占86.94%。经彩色多普勒超声检出恶性结节89例,占13.67%,检出良性结节562例,占86.33%;(2)彩色多普勒对甲状腺结节性质进行诊断及鉴别的恶性预测值为93.26%、良性预测值为99.64%、敏感度为97.65%、特异度为98.94%、准确度为98.77%、约登指数为96.59%、误诊率为1.06%、漏诊率为2.35%;(3)良性组和恶性组的患者在彩色多普勒超声诊断下,边缘(P=0.0085)、钙化(P=0.0076)、包膜情况(P=0.0142)、内部回声(低回声P<0.0001,中回声P=0.0485,高回声P=0.0412,混合回声P=0.0446)等方面有差异性。结论:彩色多普勒超声对甲状腺结节的性质进行鉴别和诊断有较高的价值,能尽早明确患者的病症和表现,可以为临床治疗工作提供科学的参考依据。

Objective:To study the application value of color Doppler ultrasound in the diagnosis and differential diagnosis of thyroid nodules.Methods:651 patients who underwent thyroid examination in our hospital from March 2022 to January 2023 were selected as the research subjects.After admission,all subjects were subjected to color Doppler ultrasound examination,and pathological biopsy was performed on the subjects.The results of pathological biopsy were used as the gold standard to determine the role of color Doppler ultrasound in the diagnosis and differential diagnosis of thyroid nodules.Results:①Pathological biopsy detected 85 cases of malignancy,accounting for 13.06%,and the remaining 566 cases were benign nodules,accounting for 86.94%.Color Doppler ultrasound detected 89 cases of malignant nodules,accounting for 13.67%,and 562 cases of benign nodules,accounting for 86.33%;②The malignant prediction value of color Doppler ultrasound for the diagnosis and differentiation of thyroid nodules was 93.26%,the benign prediction value was 99.64%,the sensitivity was 97.65%,the specificity was 98.94%,the accuracy was 98.77%,the Youden index was 96.59%,the misdiagnosis rate was 1.06%,and the missed diagnosis rate was 2.35%;③There were differences in the edge(P=0.0085),calcification(P=0.0076),envelope condition(P=0.0142),internal echo(low echo P<0.0001,medium echo P=0.0485,high echo P=0.0412,mixed echo P=0.0446)between the benign and malignant groups under the diagnosis of color Doppler ultrasound.Conclusion:Color Doppler ultrasound has high value in the differential diagnosis and diagnosis of thyroid nodules,which can clarify the patient’s symptoms and manifestations as early as possible,and provide scientific reference for clinical treatment.