CAJ | 학술논문

目的分析甲状腺良恶性结节超声特点,探讨甲状腺恶性结节超声危险因素,降低不必要的穿刺活检或手术.方法回顾性分析触诊或超声检查发现并进行手术和(或)穿刺活检的2 453例甲状腺结节,以手术后病理为金标准,比较良恶性结节超声特点,观察结节数目、前后径与横径比(AP/TR)、钙化模式、性质、回声、边缘、结节内及周边血流.结果恶性结节中单发结节、AP/TR≥1、低回声、微小钙化、边缘不规整、结节内少或富含血流超声等影像特点发生率显著高于良性结节(P＜0.05)；单因素分析显示结节若为单发结节、AP/TR≥1、实性结节、边缘不规整、低回声、微小钙化、结节内少或富含血流时,则恶性发生风险显著升高(P＜0.05)；多因素回归分析AP/TR≥1、实性结节、边缘不规整、低回声、微小钙化为甲状腺恶性结节的独立危险因素(P＜0.05),低回声(P=0.016,OR=7.685)、微小钙化(P=0.005,OR=7.515)具有强有力的预测作用.结论超声对甲状腺结节有较高的诊断价值,综合甲状腺恶性结节图像特点可提高鉴别诊断的准确率,有助于降低不必要的穿刺活检和手术.
목적 분석갑상선량악성결절초성특점,탐토갑상선악성결절초성위험인소,강저불필요적천자활검혹수술.방법 회고성분석촉진혹초성검사발현병진행수술화(혹)천자활검적2 453례갑상선결절,이수술후병리위금표준,비교량악성결절초성특점,관찰결절수목、전후경여횡경비(AP/TR)、개화모식、성질、회성、변연、결절내급주변혈류.결과 악성결절중단발결절、AP/TR≥1、저회성、미소개화、변연불규정、결절내소혹부함혈류초성등영상특점발생솔현저고우량성결절(P＜0.05)；단인소분석현시결절약위단발결절、AP/TR≥1、실성결절、변연불규정、저회성、미소개화、결절내소혹부함혈류시,칙악성발생풍험현저승고(P＜0.05)；다인소회귀분석AP/TR≥1、실성결절、변연불규정、저회성、미소개화위갑상선악성결절적독립위험인소(P＜0.05),저회성(P=0.016,OR=7.685)、미소개화(P=0.005,OR=7.515)구유강유력적예측작용.결론 초성대갑상선결절유교고적진단개치,종합갑상선악성결절도상특점가제고감별진단적준학솔,유조우강저불필요적천자활검화수술.
Objective To determine the important sonographic features of malignant thyroid nodules,and to reduce the number of unnecessary invasive fine needle aspiration (FNA) and thyroidectomy.Methods The sonographic and pathological data were studied in 2 453 thyroid nodules collected from 2005 to 2012,fine needle aspiration and/or thyroidectomy were performed.Results Microcalcification,blurred nodular margin,AP/TR ≥ 1,solitary,and hypoechoic appearance were more common in malignant nodules as compared with benign nodules (P＜0.05).Logistic regression analysis showed that microcalcification,blurred nodular margin,AP/TR(antero-posterior and transversal diameters) ≥ 1,solid and hypoechoic appearance were independent determinants of malignancy under ultrasound examination of thyroid nodules (P＜0.05).Conclusions Ultrasound findings are of high diagnostic value for malignant thyroid nodules,and integrated image features can improve the differential diagnosis.