超声量化评分在甲状腺良恶性结节鉴别诊断中的应用价值

目的 探讨超声对甲状腺良恶性结节的鉴别诊断价值,尝试建立超声量化评分系统。方法 应用超声量化评分对332个甲状腺结节进行评分,与手术组织病理结果进行对照,评价超声量化评分法诊断甲状腺良恶性结节的准确性。结果 手术组织病理证实良性结节248个,恶性结节84个;在边界、边缘、内部结构、回声、纵横比、微钙化及后方声衰减7项超声特征方面,甲状腺恶性结节与良性结节比较差异有统计学意义（P〈0.01）;AUC为0.940时,以超声量化评分≥3分为恶性结节判定标准,超声量化评分诊断甲状腺恶性结节的敏感性、特异性、准确性分别为85.71%、92.74%、90.96%,诊断甲状腺良性结节的敏感性、特异性、准确性分别为92.74%、85.71%、90.96%。结论 超声量化评分有助于甲状腺良恶性结节的鉴别诊断。

Application of ultrasonic quantitative score in the differential diagnosis of benign and malignant nodules of thyroid

Objective To investigate the value of ultrasonography to the differential diagnosis of benign and malignant thyroid nodules and try to establish ultrasonic quantitative grading system. Methods A total of 332 thyroid nodules undergoing preoperative conventional ultrasound were assessed by ultrasonic quantitative score, and were compared with the histopathological results to evaluate the accuracy of ultrasonic quantitative score in the diagnosis of thyroid nodules. Results Histopathology confirmed 248 benign nodules and 84 malignant nodules. There were significant differences in the boundary, margin, internal structure, echo, aspect ratio, microcaleification and posterior acoustic attenuation between malignant and benign thyroid nodules （P〈0.01）. Taking the cut-off point of ≥ 3 as the standard for diagnosing malignant thyroid nodules, when AUC was 0. 940, the sensitivity, specificity and accuracy of ultrasonic quantitative score were 85. 71%, 92. 74% and 90. 96% respectively for malignant thyroid nodules, and were 92. 74%, 85.71% and 90.96% for benign thyroid nodules. Conclusion The ultrasonic quantitative score helps the differential diagnosis of benign and malignant thyroid nodules.