摘要
目的研究甲状腺良性结节与乳头状甲状腺癌在超声影像学表现上的差异。方法选取本院2013年6月至2015年6月收治的221例甲状腺良性结节及乳头状甲状腺癌患者为研究对象,根据病理确诊结果将其中143例甲状腺良性结节患者纳入良性组,将78例乳头状甲状腺癌患者纳入恶性组。两组患者均行甲状腺超声检查,比较两组患者超声征象分布的差异,对存在显著性差异的超声征象计算其对乳头状甲状腺癌的诊断价值。结果分别比较两组患者的10项超声征象:两组患者超声声像图中区域数、结节数、结节大小、病灶边界及声晕变量5项指标的征象比较均无明显差异(P>0.05);而病灶纵横比、病灶边缘、内部回声水平、内部结构及病灶内钙化灶形状的差异明显(P<0.01)。其中,内部低回声诊断恶性结节的灵敏度最高(82.05%),微小钙化诊断恶性结节的特异度最高(93.00%),纵横比≥1诊断恶性结节的诊断准确率最高(79.19%)。结论对于存在微小钙化或纵横比≥1的甲状腺结节,应高度怀疑恶性结节的可能。而对于缺少上述2项征象,出现病灶边缘不规则、内部低回声或实性回声的甲状腺结节,不排除恶性结节的可能。
Objective To explore the differences of ultrasound imaging between benign thyroid nodules and papillary thyroid cancer. Method From June 2013 to June 2015, 221 patients with thyroid nodules in our hospital were enrolled into the research. According to the results of pathological diagnosis, 143 cases with benign thyroid nodules were enrolled into benign group when 78 cases with papillary thyroid cancer were enrolled into malignant group. Compared the differences of ultrasonography appearances between the two groups. Calculated the diagnostic value ultrasonography appearances which had statistical differences between the two groups in the diagnosis of papillary thyroid cancer. Result 10 items of ultrasonography appearances were compared between the two groups in this research. There were no significant differences of region number, nodule number, node size, lesions border and echo halo in ultrasound features between the two groups （P 〉 0.05）. There were significant differences of A/ T, lesion outline, internal echo level, intemal structure and calcifications shape between groups （P 〈 0.05）, in those ultrasound manifestations, low internal echo hadthe best sensitivity （82.05%）, microcalcification showed the highest specificity （93.00%）, A/T ≥ 1 had the best accuracy of diagnosis （79.19%）. Conclusion It should be highly suspected for malignant nodules when the nodules shows the ultrasound manifestations of microcalcification or A/ T ≥1. When lacking the two signs above but performing irregular edges, low internal echo or solid mass echoic, the possibility of malignant nodules should not be ruled out.
出处
《中国医学前沿杂志（电子版）》
2016年第10期56-59,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
甲状腺结节
乳头状甲状腺癌
超声检查
鉴别诊断
钙化
l Thyroid nodule
Papillary thyroid cancer
Ultrasonography
Differential diagnosis
Calcification
