超声评分对细胞学未定性的甲状腺结节良恶性鉴别的价值  

Diagnostic Value of Ultrasound Score in Discriminating Benign and Malignant Thyroid Nodules Showing Indeterminate Cytology

作　　者：程溥[1] 郑华敏[2] 邹章勇 何秋香[3] 戴璇璇[1] 张筱骅[1] 

机构地区：[1]温州医科大学附属第一医院肿瘤外科,温州市325000 [2]温州医科大学附属第一医院超声影像科,温州市325000 [3]温州医科大学附属第一医院病理科,温州市325000

出　　处：《中国超声医学杂志》2014年第1期11-14,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家863高技术研究发展计划(No.2012AA02A210)

摘　　要：目的通过评估术前细胞学检查未定性的甲状腺结节的超声图像特征,并对其进行半定量分析,建立一个实用的超声评分系统用以判断良恶性从而指导进一步的治疗。方法回顾性分析117例患者共128个细胞学检查未定性的甲状腺结节,收集其甲状腺结节的超声影像学资料及术后病理结果,分析得出其相关因素并予以不同评分。结果恶性结节中成分为实性、回声不均匀、微钙化、包膜不完整或消失、边界不清晰、内部血流丰富发生率均高于良性结节(P<0.05)。超声积分在恶性结节组与良性结节组间差异有统计学意义(P<0.001)。以超声积分≥4分为分界值,其灵敏度为91.4%,特异度为82.9%。结论超声积分对细胞学检查未定性的甲状腺结节良恶性鉴别具有一定的预测价值,当超声积分≥4时需考虑恶性的可能。Objective To build and assess the diagnostic accuracy of a useful preoperative ultrasound scoring sys- tem using the US features in the treatment of thyroid nodules with indeterminate cytology. Methods From January 2005 to May 2012, 117 patients with 128 thyroid nodules with indeterminate cytology diagnosed by ultrasound and subsequent ultrasound-guided fine-needle aspiration biopsy were retrospectively analyzed. The US and final pathologi- cal data were collected to determine the relevant factors and different scores. Results There were significant differ- ences （P〈0. 05） among US features including solid composition, heterogeneous echo, presence of micro-calcification, no well-defined margin, absent or incomplete capsule and centrally increased vascularity between the malignant group and the benign group. The US score ≥4 was the delimitation value, with which the nodules where characterized by a 91.4% sensitivity and a 82.9% specificity. Conclusions The ultrasonic score has definite value in the differential di- agnosis bf benign and malignant thyroid nodules in the patients with indeterminate cytology, when the score is larger than 4, the possibility of malignancy should be considered.

关 键 词：细针穿刺细胞学检查 甲状腺结节 超声检查 

分 类 号：R736.1[医药卫生—肿瘤]