超声诊断儿童甲状腺良恶性结节

Ultrasound in diagnosis of malignant and benign thyroid nodules in children

目的探讨超声鉴别诊断儿童甲状腺结节良恶性的价值。方法回顾性分析经病理证实的120例甲状腺结节患儿的超声表现,比较良恶性甲状腺结节间超声特征的差异。结果 120例中,甲状腺恶性结节71例(71/120,59.17%),良性结节49例(49/120,40.83%)。良恶性甲状腺结节的超声形态、边界、边缘、内部结构、回声、钙化类型差异均有统计学意义(P均<0.05);上述超声特征诊断恶性甲状腺结节的准确率分别为80.00%(112/140)、78.57%(110/140)、78.57%(110/140)、81.43%(114/140)、82.86%(116/140)、87.86%(123/140),敏感度为68.29%(56/82)、70.73%(58/82)、73.17%(60/82)、97.56%(80/82)、90.24%(74/82)、79.27%(65/82),特异度为96.55%(56/58)、89.66%(52/58)、86.21%(50/58)、58.62%(34/58)、72.41%(42/58)、100%(58/58)。71例恶性甲状腺结节中,60例(60/71,84.51%)伴颈部淋巴结转移,14例(14/71,19.72%)伴中央区淋巴结转移,46例(46/71,64.79%)伴中央区+侧颈淋巴结转移。结论根据超声特征可有效鉴别儿童良恶性甲状腺结节。

Objective To investigate the value of ultrasound in differential diagnosis of benign and malignant thyroid nodules in children.Methods Ultrasonic manifestations of 120 children with thyroid nodules confirmed by pathology were retrospectively analyzed,and ultrasonic features of benign and malignant thyroid nodules were compared.Results Among120 cases,malignant nodules were detected in 71 cases(71/120,59.17%),while benign nodules were found in 49 cases(49/120,40.83%).There were significant differences of the shape,boundary,margin,composition,echo and calcification types between benign and malignant thyroid nodules(all P<0.05).The accuracy of the above ultrasonic features in diagnosis of malignant thyroid nodules was 80.00%(112/140),78.57%(110/140),78.57%(110/140),81.43%(114/140),82.86%(116/140),87.86%(123/140),the sensitivity was 68.29%(56/82),70.73%(58/82),73.17%(60/82),97.56%(80/82),90.24%(74/82),79.27%(65/82),and the specificity was 96.55%(56/58),89.66%(52/58),86.21%(50/58),58.62%(34/58),72.41%(42/58),100%(58/58).Among 71 cases of malignant thyroid nodules,60 cases(60/71,84.51%)were associated with cervical lymph node metastasis,14 cases(14/71,19.72%)were associated with central region lymph node metastasis,46 cases(46/71,64.79%)were simultaneously involved in the lateral compartment.Conclusion Ultrasound can effectively differentiate benign and malignant thyroid nodules in children.