超声在甲状腺结节良恶性鉴别中的应用价值

陈慧惠，侯春杰.超声在甲状腺结节良恶性鉴别中的应用价值[J].吉林医学.2013.34（28）：5236-5237

甲状腺结节；超声检查；良恶性鉴别

陈慧惠1，侯春杰2

1.浙江省杭州市预防保健门诊部特检科，浙江杭州310016；2.浙江省人民医院，浙江杭州310016

0

5236-5237

知网,万方

目的：应用ROC曲线分析来确定超声检查在甲状腺结节良恶性鉴别中所使用的评价标准，并进一步提高超声检查的诊断价值。方法：共403例甲状腺结节患者（男81例，女322例），431例甲状腺结节（恶性41例，良性390例）参与本次实验，按照结节大小分成A组（最长径＞1 cm）和B组（最长径≤1 cm）。每个结节均按照声像图特征进行超声评分，并进行超声引导下细针穿刺活检，取得病理结果。应用ROC曲线分析来评价超声总评分在甲状腺结节良恶性鉴别中的应用价值。结果：当结节最长径＞1 cm时，超声总评分的最佳诊断临界值为2，灵敏度67.7%，特异度92.6%，准确度90.4%；当结节最长径≤1 cm时，超声总评分的最佳诊断临界值为3，灵敏度80.0%，特异度95.4%，准确度94.7%。结论：超声在甲状腺结节良恶性鉴别中具有较高的诊断价值，所使用的鉴别标准个数应根据结节大小的不同而调整。 ObjectiveTo determine the evaluation standards in differentiating malignant and benign thyroid nodules of ultrasonography by using ROC curve analysis and further improve the diagnostic value of ultrasonic diagnosis.MethodA total of 403 patients with thyroid nodules ( 322 females，81 males )，431 patients with thyroid nodules ( 41 malignant cases，390 cases of benign ) participated in this experiment，according to the nodule size，they were divided into group A ( longest diameter > 1cm ) and group B ( longest diameter≤ 1cm ).Each node was scored in accordance with the sonographic features of ultrasound，and ultrasound guided fine needle aspiration biopsy，pathologic results achieved.BY ROC curve analysis，we evaluated the application value of the ultrasound total score in differentiating malignant and benign thyroid nodules.ResultsWHEN the nodule longest diameter > 1cm，ultrasound total score of the optimal diagnostic critical value was 2，the sensitivity was 67.7%，specificity was 92.6%，accuracy was 90.4%；when the nodule longest diameter≤ 1cm，ultrasound total score of the optimal diagnostic critical value was 3，the sensitivity was 80%，specificity was 95.4%，accuracy was 94.7%.ConclusionUltrasound has a high diagnostic value in differential diagnosis of benign and malignant thyroid nodules，and the differential standard number should be varied based on nodule size.