甲状腺结节最大纵断面及横断面超声对比在甲状腺癌诊断中的价值

目的探讨甲状腺结节的最大纵断面纵横比（A/T L）与最大横断面纵横比（A／TC）在甲状腺癌诊断中的价值。方法回顾性分析2012年5月至2013年4月超声诊断有甲状腺结节并行病理活检的86例患者。根据超声结果计算出各结节的A／T L及A/T C数值，并与病理诊断的准确性进行比较；同时比较分析纵横比在不同直径的甲状腺癌中的差异。结果纵横比（A／T）≥1者的恶性结节所占比例明显高于A/T〈1者，且差异有统计学意义（P〈0．05）。在直径≤1cm的结节中，A/T C≥1的恶性结节比例明显高于A／T L≥1，差异具有统计学意义（P〈0．05）。而在1cm〈直径≤2cm、直径〉2cm的结节中，A/TC≥1与A/TL≥1的恶性结节所占的比例差异无统计学意义（P〉0．05）。结论甲状腺结节的纵横比，特别是最大横断面纵横比，在甲状腺癌的判断中具有一定的诊断价值。但在应用彩超诊断甲状腺结节良恶性的同时，也还应结合其他超声影像学因素。

Value of the maximum longitudinal section and cross section ultrasound contrast in the diagnosis of thyroid carcinoma

Objective To investigate the value of thyroid nodules maximum vertical section aspect ratio （A/T L） and the maximum cross-sectional aspect ratio （A/Tc） in the diagnosis of thyroid cancer. Methods A retrospective analysis was carried out to study 86 patients with thyroid nodule from May 2012 to April 2013 treated in our hospital, both diagnosed by ultrasound and biopsy, according to ultrasound results, we calculated A/ T L and A/Tc values of each nodule, and compared the accuracy with pathological diagnosis, meanwhile contrasted the differences of the aspect ratio in the various of thyroid cancer diameters. Results The proportion of malignant nodules which A/T ≥ 1 was significantly higher than that of A/T〈1, and the difference was statistically significant （P 〈 0.05）. In the nodules diameter ≤ 1 cm, malignant nodules of A/Tc ≥ 1 were significantly higher than the proportion of A/TL ≥ 1 （P 〈 0.05）. While the proportion of malignant nodules, grouped by Afrc ≥ 1 or A/T L≥ 1, had no significant difference in diameter 〉1 cm （P 〉 0.05）. Conclusion The aspect ratio of thyroid nodules, especially the largest cross-sectional aspect ratio, has a certain value in the diagnosis of thyroid cancer. However, it also should be combined with other ultrasound imaging factors to judge benign or malignant in thyroid nodules.