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目的探讨超声诊断甲状腺微小乳头状癌的临床价值,并总结超声诊断甲状腺微小乳头状癌的影像学特征。方法选择甲状腺微小乳头状癌患者共93例(均为单一结节患者)为对象。所有患者均先经彩色超声诊断,并于术后病理证实。统计超声诊断的准确性、灵敏度和特异性。结果术前超声诊断良性病变37例(39.78%),恶性病变56例(60.21%)。术后确诊良性病变38例(40.86%),恶性病变55例(59.14%)。超声诊断准确率、灵敏度和特异度分别为94.62%、92.11%、96.36%。超声诊断主要特征为:实性低回声结节86例(92.47%);边界不清晰、形态不规则76例(84.95%);纵横比>1,切面表现为直立的橄榄核71例(76.34%);Ⅱ、Ⅲ型血流信号70例(75.27%);结节见砂粒体63例(67.74%)、后衰减37例(39.78%);转移性淋巴结35例(37.63%)。形态不规则、边缘毛糙的准确性、敏感性、特异性显著高于其他影像学特征(P<0.05)。结论超声诊断甲状腺微小乳头状癌具有较高的准确率、特异性和敏感度,是甲状腺微小乳头状癌诊断的可行方法。
Objective To investigate the clinical value of ultrasonography in the diagnosis of thyroid papillary carcinoma and to summarize the imaging features of papillary thyroid carcinoma by ultrasonography. Methods A total of 93 patients with small papillary thyroid carcinoma (all with single nodule) were selected as the target. All patients were diagnosed by color ultrasound and pathologically confirmed. Statistics ultrasound diagnostic accuracy, sensitivity and specificity. Results Preoperative ultrasound diagnosis of benign lesions in 37 cases (39.78%), 56 cases of malignant lesions (60.21%). 38 cases (40.86%) were confirmed benign lesions and 55 cases (59.14%) were malignant lesions. The diagnostic accuracy, sensitivity and specificity of ultrasound were 94.62%, 92.11% and 96.36% respectively. There were 86 cases (92.47%) with solid hypoechoic nodules, 76 cases (84.95%) with unclear border and irregular shape, and 71 cases (76.34%) with vertical aspect ratio> 1. ), 70 cases (75.27%) of type II and type III blood flow signals, 63 cases (67.74%) of nodules, 37 cases (39.78%) after attenuation and 35 cases (37.63%) of metastatic lymph nodes. The accuracy, sensitivity and specificity of irregular shape and rough edge were significantly higher than those of other imaging features (P <0.05). Conclusion Ultrasound diagnosis of small papillary thyroid carcinoma with high accuracy, specificity and sensitivity, is a viable method for the diagnosis of thyroid papillary carcinoma.