桥本甲状腺炎合并TI-RADS 4类结节良恶性的超声特征  

Ultrasonic Characteristics of Hashimoto Thyroiditis Complicated with TI-RADS Type 4 Benign and Malignant Nodules

作　　者：徐雪 单思维 邹金秀 郑艳[2] XU Xue;SHAN Siwei;ZOU Jinxiu(Department of Ultrasound,Suqian Zhongwu Hospital,Suqian Jiangsu 223800)

机构地区：[1]宿迁市钟吾医院超声医学科,江苏宿迁223800 [2]宿迁市钟吾医院病理科,江苏宿迁223800

出　　处：《医学临床研究》2025年第2期249-251,共3页Journal of Clinical Research

摘　　要：【目的】探讨预测桥本甲状腺炎(Hashimoto's thyroiditis,HT)合并TI-RADS 4类结节良恶性的超声特征。【方法】2024年1月至5月在本院经临床确诊为HT合并TI-RADS 4类结节的136例患者,均行超声引导下细针穿刺细胞学(US-FNAC)检查,分析结节的超声特征,并与Bethesda分类结果对照。根据Bethesda分类结果分为良性组(BethesdaⅡ级)和恶性组(BethesdaⅤ+BethesdaⅥ级),分析结节超声特征与结节良恶性的相关性及预测HT合并TI-RADS 4类结节为恶性的独立危险因素。【结果】单因素分析结果显示:结节回声、边缘、强回声类型与结节为恶性相关(P<0.05),结节实性构成、是否有局灶性强回声、形状、位置与结节为恶性无相关性(P>0.05)。多因素分析结果显示:低回声、局灶性强回声类型为HT合并TI-RADS 4类结节为恶性的独立危险因素。恶性组结节粗大钙化占比低于良性组,微钙化占比高于良性组,差异有统计学意义(P<0.05)。【结论】在HT合并的TI-RADS 4类结节中,有低回声及点状强回声结节的恶性风险较高。【Objective】To investigate the ultrasonic characteristics of Hashimoto's thyroiditis(HT)combined with TI-RADS in the 4 types of benign and malignant nodules.【Methods】From January to May 2024,136 patients clinically diagnosed as HT with TI-RADS type 4 nodules in our hospital were examined by ultraso-guided fine needle aspiration cytology(US-FNAC)to analyze the ultrasonic characteristics of nodules and compare them with Bethesda classification results.According to the results of Bethesda classification,they were divided into the benign group(Bethesda gradeⅡ)and the malignant group(gradeⅤ+Ⅵ).The correlation between the ultrasonic features of nodules and the benign and malignant nodules was analyzed,and the independent risk factors for malignant nodules of type 4 of HT combined with TI-RADS were predicted.【Results】Univariate analysis showed that the type of nodule echo,edge and strong echo were correlated with the malignancy of nodule(P<0.05),but the solid structure of nodule,whether there was strong focal echo,shape and location were not correlated with the malignancy of nodule(P>0.05).The results of multi-factor analysis showed that low echo and strong focal echo type HT combined with TI-RADS type 4 nodules were independent risk factors for malignancy.The proportion of coarse calcification in the malignant group was lower than that in the benign group,and the proportion of microcalcification was higher than that in the benign group,with statistical significance(P<0.05).【Conclusion】Among the 4 types of TI-RADS nodules with HT,the malignant risk of low echo and dot strong echo nodules is higher.

关 键 词：桥本病 甲状腺结节 超声检查 诊断 鉴别 

分 类 号：R736.1[医药卫生—肿瘤]