健康体检中彩色高频超声用于不同性质甲状腺结节诊断的价值  

Diagnostic value of high-frequency color ultrasound for different types of thyroid nodules during healthy examinations

作　　者：钱晓兰 钱燕君 史丽群 胡程双 吴良玉 QIAN Xiaolan;QIAN Yanjun;SHI Liqun;HU Chengshuang;WU Liangyu(Huadong Sanatorium,Wuxi 214065 China)

机构地区：[1]华东疗养院,江苏无锡214065

出　　处：《中国辐射卫生》2022年第4期502-506,共5页Chinese Journal of Radiological Health

基　　金：华东疗养院院级课题(202007)

摘　　要：目的评价健康体检中彩色高频超声用于诊断不同性质甲状腺结节的价值。方法以150例经超声诊断为甲状腺结节异常的患者为研究对象,以甲状腺手术标本组织病理学检查结果作为金标准,评价超声诊断鉴别甲状腺结节良恶性的敏感度、特异度、阳性预测值、阴性预测值和准确度。结果150例患者中均为单一甲状腺结节,组织病理学检查发现良性甲状腺结节102例、恶性48例。以组织病理学检查结果为金标准,微钙化用于预测甲状腺结节良恶性的准确度最高,为98.1%(χ^(2)=45.67,P=0.001),其次为甲状腺结节纵横比>1(92.1%;χ^(2)=34.06,P=0.001)、中央型血流(82.0%;χ^(2)=13.29,P=0.001)、不规则晕环(76.0%;χ^(2)=6.15,P=0.008)和低回声(70.3%;χ^(2)=10.63,P=0.001)。超声诊断甲状腺结节良恶性的敏感度为100.0%、特异度为94.1%、阳性预测值为88.9%、阴性预测值为100.0%、准确度为96.0%(χ^(2)=41.830,P<0.001)。结论彩色高频超声鉴别甲状腺结节良恶性的准确度较高,微钙化和甲状腺结节纵横比>1用于鉴别甲状腺结节良恶性的参考价值较高。Objective To evaluate the value of high-frequency color ultrasound for different types of thyroid nodules during healthy examinations.Methods A total of 150 subjects with ultrasound diagnosis of thyroid nodule abnormality were enrolled.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ultrasound diagnosis for differentiating benign and malignant thyroid nodules were evaluated with histopathological examinations of surgical thyroid specimens as a gold standard.Results A single thyroid nodule was found in all patients,and histopathological examinations identified 102 benign thyroid nodules and 48 malignant nodules.Microcalcification showed the highest accuracy for prediction of benign and malignant thyroid nodules(98.1%;χ^(2)=45.67,P=0.001),followed by taller than wider shape of thyroid nodule(92.1%;χ^(2)=34.06,P=0.001),central vascularity(82.0%;χ^(2)=13.29,P=0.001),halo(76.0%;χ^(2)=6.15,P=0.008)and hypoechogenicity(70.3%;χ^(2)=10.63,P=0.001).In addition,ultrasound diagnosis showed a 100.0%sensitivity,a 94.1%specificity,a 88.9%positive predictive value,a 100.0%negative predictive value and a 96.0%accuracy for differentiation between benign and malignant thyroid nodules(χ^(2)=41.830,P<0.001).Conclusion High-frequency color ultrasound has a high diagnostic accuracy for differentiating benign and malignant thyroid nodules,and microcalcification and taller than wider shape of thyroid nodule exhibit high values for predicting the malignancy of thyroid nodules.

关 键 词：甲状腺结节 超声诊断 鉴别诊断 彩色高频超声 

分 类 号：R581[医药卫生—内分泌]