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目的探讨部分甲状腺囊性结节超声特征对占位性病变良恶性的鉴别诊断效果。方法使用超声对128例经术后病理证实的部分甲状腺囊性结节患者进行诊断,与术后病理对比,观察超声特征。结果 128例患者中,102例良性,26例恶性。超声诊断的灵敏度、特异度、准确度分别为92.31%、98.03%、96.88%。纵横比大于1、边界毛刺或微小分叶与结节恶性有关(P<0.05),海绵状结构和边界光滑与结节良性有关(P<0.05),结节数目与良恶性无关(P>0.05)。对于结节内部实性部分,内部实性偏心锐角、微钙化、低回声及极低回声与结节恶性有关(P<0.05)。Logistic回归分析显示极低回声、低回声、纵横比、微钙化和内部实性偏心锐角是预测结节恶性的重要因素。结论超声诊断的声像特征可用于鉴别诊断占位性病变中的部分甲状腺囊性结节。
Objective To investigate the differential diagnosis of thyroid cystic nodules by sonography on the benign and malignant space-occupying lesions. Methods Ultrasound was used to diagnose 128 cases of thyroid cystic nodules confirmed by postoperative pathology. The characteristics of the ultrasound were compared with postoperative pathology. Results Of the 128 patients, 102 were benign and 26 were malignant. The sensitivity, specificity, and accuracy of ultrasound diagnosis were 92.31%, 98.03%, and 96.88%, respectively. The aspect ratio greater than 1, boundary burr or minute lobulation was related to the malignant of the nodule (P<0.05). The spongy structure and boundary were smooth and benign (P<0.05), and the number of nodules was not related to benign and malignant (P>0.05). ). For the internal solid part of the nodule, internal solid acute eccentricity, microcalcification, hypoechoic and hypoechoic were associated with malignant nodules (P<0.05). Logistic regression analysis showed that very low echo, hypoechoic, aspect ratio, microcalcification, and internal solid eccentricity were important factors in predicting the malignancy of the nodule. Conclusion The sonographic features of ultrasound diagnosis can be used to differentially diagnose some thyroid cystic nodules in space occupying lesions.