桥本甲状腺炎背景下甲状腺微小乳头状癌超声图像特征及其价值分析  

Ultrasonographic characteristics and value of thyroid micropapillary carcinoma in the background of Hashimoto thyroiditis

作　　者：陈贝贝 罗新滨 翟婷婷 Chen Beibei;Luo Xinbin;Zhai Tingting(Department of Ultrasound,Xinyang People′s Hospital,Henan 464007,China;不详)

机构地区：[1]河南省信阳市人民医院超声科,464007 [2]河南省信阳市人民医院普外科,464007

出　　处：《实用医学影像杂志》2025年第1期33-36,共4页Journal of Practical Medical Imaging

摘　　要：目的 探究桥本甲状腺炎(HT)背景下甲状腺微小乳头状癌(PTMC)超声图像特征及其价值。方法 纳入98例均为2021年7月至2023年12月经我院手术病理证实为HT患者,并选择经超声评估甲状腺结节最大径≤1 cm的79例(82个结节)HT患者作为本次研究对象,所有患者术前均行超声检查。分析HT患者甲状腺结节良恶性、对比HT患者不同性质甲状腺结节的超声特征表现、对比HT背景下PTMC及良性微小结节患者结节前后径及上下径,“金标准”为病理学检查结果,分析超声在HT背景下PTMC诊断价值,并计算与“金标准”的一致性。结果 79例(82个结节)HT患者经手术病理证实恶性结节54个,良性结节28个。HT背景下PTMC患者微钙化、低血供程度、边缘为主的血供模式检出率均高于良性微小结节,差异有统计学意义(P<0.05)。内部回声、内部结构、形态、声晕、边界、纵横比对比,差异无统计学意义(P>0.05)。HT背景下PTMC患者甲状腺结节前后径及上下径均大于良性微小结节,差异有统计学意义(P<0.05)。超声检查诊断HT背景下PTMC的灵敏度为93%,特异度为54%,准确度为79%,阳性预测值为79%,阴性预测值为79%。一致性检验显示,超声检查与病理检查在诊断HT背景下PTMC中的一致性尚可(Kappa值=0.500,P<0.001)。结论超声在HT背景下PTMC应用中能够有效明确超声图像特征,且诊断一致性尚可,可为临床诊疗提供有效的参考,值得推广应用。Objective To explore the ultrasonographic characteristics and value of thyroid micropapillary carcinoma(PTMC)in the background of Hashimoto thyroiditis(HT).Methods Ninety-eight patients in our hospital from July 2021 to December 2023 were confirmed as HT by surgical pathology in our hospital,and 79 patients(82 nodules)with the largest diameter of thyroid nodule≤1 cm were selected as the subjects of this study.All patients underwent preoperative ultrasound examination.Benign and malignant thyroid nodules in HT patients were analyzed,ultrasonic characteristics of different thyroid nodules in HT patients were compared,and anterograde and anterograde nodular diameters and anterograde diameters in PTMC and benign micro-nodules in HT patients were compared.The"gold standard"was the pathological examination results.The diagnostic value of ultrasound in PTMC in HT patients was analyzed,and the consistency with the"gold standard"was calculated.Results Fifty-four malignant nodules and 28 benign nodules were confirmed pathologically in 79 patients with HT(82 nodules).In the context of HT,the detection rates of microcalcification,low blood supply degree and marginal blood supply pattern in PTMC patients were higher than those of benign micro-nodules,with statistical differences(P<0.05).There were no significant differences in internal echo,internal structure,shape,halo,boundary and aspect ratio(P>0.05).In the context of HT,the diameter of thyroid nodules in PTMC patients was larger than that of benign minor nodules,with statistical difference(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 93%,54%,79%,79%and 79%respectively in the diagnosis of PTMC in HT background.Consistency test showed that the consistency between ultrasound examination and pathological examination in the diagnosis of PTMC in the context of HT was reasonable(Kappa value=0.500,P<0.001).Conclusion Ultrasound in the application of PTMC under the background of HT can effectively define ultrasonic ima

关 键 词：甲状腺癌 乳头状 桥本病 超声检查 诊断 

分 类 号：R73[医药卫生—肿瘤]