超声检查在甲状腺弥漫性病变合并结节患者诊断中的应用价值
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摘要
目的分析超声检查在甲状腺弥漫性病变合并结节患者诊断中的应用价值。方法回顾性分析2014年1月～2017年3月我院接诊的50例甲状腺弥漫性病变合并甲状腺结节患者的超声资料,所有患者均经穿刺活检证实。统计病理诊断结果,对比超声检查和病理诊断结果,分析良恶性结节患者的超声声像特征。结果经穿刺活检50例患者共检出53个甲状腺结节,病理诊断结果显示良性结节34个(64.15%),恶性结节19个(35.85%)。超声检查甲状腺良恶性结节的灵敏度为70.59%(24/34)、特异度为78.95%(15/19)、误诊率为21.05%(4/19)、漏诊率为29.41%(10/34)。恶性结节患者边界不清楚率、不均质回声率、不规则形态率、点状钙化灶发生率、Ⅲ级血流分布率及阻力指数≥0.7患者比例均明显高于良性结节患者,良恶性结节患者的超声声像特征比较差异有统计学意义(P<0.05)。结论超声检查声像特征对鉴别甲状腺弥漫性病变合并结节具有一定的临床价值,值得临床推广应用。
Objective To analyze the application value of ultrasonography in the diagnosis of patients with thyroid diffuse lesions complicated with nodules. Methods The ultrasound data of 50 patients with thyroid diffuse lesions complicated with thyroid nodules who were admitted to our hospital from January 2014 to March 2017 were retrospectively analyzed. All patients were confirmed diagnosis by needle biopsy. Pathological diagnosis results were statistically analyzed, and the ultrasound examination and pathological diagnosis results were compared. The ultrasound imaging features of patients with benign and malignant nodules were analyzed. Results A total of 53 thyroid nodules were detected among 50 patients undergoing needle biopsy. Pathological diagnosis showed 34 benign nodules(64.15%) and 19 malignant nodules(35.85%). The sensitivity of ultrasound examination of benign and malignant thyroid nodules was 70.59%(24/34), the specificity was 78.95%(15/19), the misdiagnosis rate was 21.05%(4/19), and missed diagnosis rate was29.41%(10/34). The patient proportion with the boundary unclear rate, heterogeneous echo rate, irregular morphology rate, incidence of punctate calcification, grade Ⅲ blood flow distribution rate and resistance index ≥0.7 in the patients with malignant nodules were significantly higher than those in the patients with benign nodules. Ultrasonographic features of the patients with benign and malignant nodules were significantly different(P<0.05). Conclusion Ultrasonographic imaging features have a certain clinical value in distinguishing thyroid diffuse lesions complicated with nodules,which is worthy of clinical promotion and application.
Objective To analyze the application value of ultrasonography in the diagnosis of patients with thyroid diffuse lesions complicated with nodules. Methods The ultrasound data of 50 patients with thyroid diffuse lesions complicated with thyroid nodules who were admitted to our hospital from January 2014 to March 2017 were retrospectively analyzed. All patients were confirmed diagnosis by needle biopsy. Pathological diagnosis results were statistically analyzed, and the ultrasound examination and pathological diagnosis results were compared. The ultrasound imaging features of patients with benign and malignant nodules were analyzed. Results A total of 53 thyroid nodules were detected among 50 patients undergoing needle biopsy. Pathological diagnosis showed 34 benign nodules(64.15%) and 19 malignant nodules(35.85%). The sensitivity of ultrasound examination of benign and malignant thyroid nodules was 70.59%(24/34), the specificity was 78.95%(15/19), the misdiagnosis rate was 21.05%(4/19), and missed diagnosis rate was29.41%(10/34). The patient proportion with the boundary unclear rate, heterogeneous echo rate, irregular morphology rate, incidence of punctate calcification, grade Ⅲ blood flow distribution rate and resistance index ≥0.7 in the patients with malignant nodules were significantly higher than those in the patients with benign nodules. Ultrasonographic features of the patients with benign and malignant nodules were significantly different(P<0.05). Conclusion Ultrasonographic imaging features have a certain clinical value in distinguishing thyroid diffuse lesions complicated with nodules,which is worthy of clinical promotion and application.
引文
[1]章生龙,邓克学,隋秀芳,等.声触诊组织定量技术在甲状腺弥漫性病变中的应用价值[J].安徽医科大学学报,2014,49(8):1161-1163.
[2]杨锦茹,雷红霞,宋艳,等.实时超声弹性成像在鉴别诊断甲状腺结节性质中的价值[J].西安交通大学学报(医学版),2014,35(5):686-689.
[3]熊专,孙晖,万姗,等.不同性质甲状腺结节临床特征的分析[J].华中科技大学学报(医学版),2014,43(4):444-448.
[4]马步云,金亚,Sundar PS,等.甲状腺乳头状癌的超声造影表现及其病理基础[J].四川大学学报(医学版),2014,45(6):997-1000.
[5]彭怡平.超声弹性成像和常规超声诊断甲状腺良恶性结节的效果分析[J].中国当代医药,2017,24(12):113-115.
[6]郇婕,苏磊,刘保娴,等.超声新技术在甲状腺良恶性结节诊断中的价值[J].中山大学学报(医学科学版),2014,35(6):889-896.
[7]孙辉,刘晓莉.甲状腺癌规范化诊治理念更新及其意义[J].中国实用外科杂志,2015,35(1):72-75.
[8]杨晓,罗文,刘海静,等.超声造影成像对弥漫性病变下甲状腺结节的评价[J].中国超声医学杂志,2017,33(5):392-394.
[9]李军,徐上知,杜婷婷,等.常规超声及实时弹性成像和声脉冲辐射力弹性成像鉴别甲状腺结节良恶性的临床诊断试验[J].中国全科医学,2015,18(6):720-723.
[10]凯娇·木哈西,马富成.超声弹性成像与常规超声对甲状腺结节诊断价值的Meta分析[J].中国医学影像学杂志,2015,23(1):45-49,55.
[11]刘玉辉,王文玲,王毅,等.超声引导下经皮微波消融甲状腺术后复发结节的临床研究[J].临床耳鼻咽喉头颈外科杂志,2015,29(7):622-624.
[12]费腾,陈亚青.甲状腺癌超声诊断的研究进展[J].中国癌症杂志,2015,25(4):316-320.
[13]张艳,罗渝昆,唐杰,等.甲状腺弥漫性病变合并甲状腺癌的超声诊断价值[J].中国医学科学院学报,2015,37(3):290-293.
[14]徐飞,陆永萍,刘蕊,等.实时剪切波超声弹性成像对甲状腺弥漫性病变的诊断价值[J].重庆医学,2015,44(18):2570-2571.
[15]李小鹏,张红丽,何鑫,等.甲状腺良恶性结节超声造影特征与病理微血管密度的相关性研究[J].中国临床医学影像杂志,2015,26(9):631-634.
[16]李进叶,宋歌声,宋吉清,等.宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析[J].山东大学学报(医学版),2016,54(3):81-86.
[2]杨锦茹,雷红霞,宋艳,等.实时超声弹性成像在鉴别诊断甲状腺结节性质中的价值[J].西安交通大学学报(医学版),2014,35(5):686-689.
[3]熊专,孙晖,万姗,等.不同性质甲状腺结节临床特征的分析[J].华中科技大学学报(医学版),2014,43(4):444-448.
[4]马步云,金亚,Sundar PS,等.甲状腺乳头状癌的超声造影表现及其病理基础[J].四川大学学报(医学版),2014,45(6):997-1000.
[5]彭怡平.超声弹性成像和常规超声诊断甲状腺良恶性结节的效果分析[J].中国当代医药,2017,24(12):113-115.
[6]郇婕,苏磊,刘保娴,等.超声新技术在甲状腺良恶性结节诊断中的价值[J].中山大学学报(医学科学版),2014,35(6):889-896.
[7]孙辉,刘晓莉.甲状腺癌规范化诊治理念更新及其意义[J].中国实用外科杂志,2015,35(1):72-75.
[8]杨晓,罗文,刘海静,等.超声造影成像对弥漫性病变下甲状腺结节的评价[J].中国超声医学杂志,2017,33(5):392-394.
[9]李军,徐上知,杜婷婷,等.常规超声及实时弹性成像和声脉冲辐射力弹性成像鉴别甲状腺结节良恶性的临床诊断试验[J].中国全科医学,2015,18(6):720-723.
[10]凯娇·木哈西,马富成.超声弹性成像与常规超声对甲状腺结节诊断价值的Meta分析[J].中国医学影像学杂志,2015,23(1):45-49,55.
[11]刘玉辉,王文玲,王毅,等.超声引导下经皮微波消融甲状腺术后复发结节的临床研究[J].临床耳鼻咽喉头颈外科杂志,2015,29(7):622-624.
[12]费腾,陈亚青.甲状腺癌超声诊断的研究进展[J].中国癌症杂志,2015,25(4):316-320.
[13]张艳,罗渝昆,唐杰,等.甲状腺弥漫性病变合并甲状腺癌的超声诊断价值[J].中国医学科学院学报,2015,37(3):290-293.
[14]徐飞,陆永萍,刘蕊,等.实时剪切波超声弹性成像对甲状腺弥漫性病变的诊断价值[J].重庆医学,2015,44(18):2570-2571.
[15]李小鹏,张红丽,何鑫,等.甲状腺良恶性结节超声造影特征与病理微血管密度的相关性研究[J].中国临床医学影像杂志,2015,26(9):631-634.
[16]李进叶,宋歌声,宋吉清,等.宝石能谱CT与常规超声对甲状腺结节良恶性诊断价值的对照分析[J].山东大学学报(医学版),2016,54(3):81-86.