高频超声联合血清促甲状腺激素总三碘甲状腺原氨酸总甲状腺素在甲状腺结节良恶性诊断的临床价值分析  

Clinical value of high frequency ultrasound combined with serum thyrotropin,triiodothyronine,total thyroxine in diagnosis of thyroid nodules

作　　者：江金武 Jiang Jinwu(Department of Ultrasonography,Putian Shengxing Hospital,Putian 351146,China)

机构地区：[1]莆田盛兴医院超声科,莆田351146

出　　处：《实用医技杂志》2024年第7期497-500,I0002,共5页Journal of Practical Medical Techniques

摘　　要：目的探讨高频超声联合血清促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)在甲状腺结节良恶性诊断的临床价值。方法回顾性分析选择2021年1月至2022年12月本院收治的156例甲状腺结节患者为研究对象,根据术后病理学检查结果结节性质分为良性组(96例)和恶性组(60例)。156例甲状腺结节患者术前均进行血清检查(TSH、TT3和TT4)及高频超声检查,比较2组高频超声检查参数(舒张期最低血流速度、搏动指数和阻力指数)及血清水平(TSH水平、TT3水平及TT4水平),分析甲状腺结节患者各血清水平与高频超声检查参数的关系,高频超声联合血清TSH、TT3、TT4在诊断良恶性甲状腺结节的临床价值。结果以病理诊断为金标准,2组患者的边界情况、钙化和声晕情况、血流信号、舒张期最低血流速度、搏动指数、阻力指数及血清水平(TSH、TT3、TT4)比较,差异有统计学意义(P<0.05);多因素结果显示,患者微钙化、声晕、1级以上血流信号、高频超声参数(舒张期最低血流速度、搏动指数和阻力指数)及血清水平(TSH、TT3、TT4)是甲状腺结节患者结节发生恶性病变的独立因素;受试者工作特征曲线(ROC)分析,高频超声联合血清TSH、TT3、TT4水平诊断恶性甲状腺结节的ROC曲线下面积(AUC)(95%CI)为0.965(0.941,0.989),区分度良好,该模型的约登指数为0.791,灵敏度为0.833,特异度为0.958。结论患者微钙化、声晕、1级以上血流信号、高频超声参数及血清水平是甲状腺结节患者结节发生恶性病变的危险因素,高频超声联合血清TSH、TT3、TT4在甲状腺结节良恶性的诊断有较好的临床价值,值得临床推广使用。Objective To investigate the clinical value of high frequency ultrasound combined with serum thyrotropin(TSH),total triiodothyronine(TT3)and total thyroxine(TT4)in the diagnosis of benign and malignant thyroid nodules.Methods A retrospective analysis was conducted on 156 patients with thyroid nodules admitted to our hospital from January 2021 to December 2022,and were divided into benign group(96 cases)and malignant group(60 cases)according to the postoperative pathology.Preoperative serum(TSH,TT3 and TT4)and high frequency ultrasound were performed in 156 patients with thyroid nodules.The parameters of high frequency ultrasound(minimum diastolic blood flow velocity,pulsation index and resistance index)and serum level(TSH level,TT3 level and TT4 level)were compared.Results There were significant differences in boundary condition,calcification and halo,blood flow signal,minimum diastolic blood flow velocity,pulsation index,resistance index and serum level(TSH、TT3、TT4)between the two groups(P<0.05).The results showed that microcalcification,acoustic halo,blood flow signal above level 1,high frequency ultrasound parameters(minimum diastolic blood flow velocity,pulsation index and resistance index)and serum level(TSH、TT3、TT4)were independent factors of nodule malignancy in patients with thyroid nodules.High frequency ultrasound combined with serum TSH,TT3 and TT4 levels was used to diagnose malignant thyroid nodules.The AUC of ROC(95%CI)was 0.965(0.941,0.989),and the differentiation was good.The Yoden value,sensitivity and specificity of the model was approximately 0.791,0.833 and 0.958,respectively.Conclusions Microcalcification,halo,blood flow signal above level 1,high frequency ultrasound parameters and serum level are the risk factors of nodule malignancy in patients with thyroid nodules.

关 键 词：甲状腺结节 高频超声 促甲状腺激素 总三碘甲状腺原氨酸 总甲状腺素 临床价值 

分 类 号：R581[医药卫生—内分泌] R446.11[医药卫生—内科学]