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目的探讨超声显示甲状腺不同类型的钙化对于良恶性结节的鉴别价值。方法回顾性分析在我院进行超声检查显示261个含不同类型钙化的甲状腺结节,所有结节均有手术病理结果,观察分析微钙化、粗大钙化、环状钙化及混合钙化在良恶性结节中所占的比例及钙化结节中良恶性的发生率。结果 261个甲状腺钙化结节中恶性结节发生率83.52%(218/261)明显高于良性结节16.48%(43/261),差异有统计学意义,恶性钙化结节中乳头状癌占95.41%(208/218),良性钙化结节中结节性甲状腺肿占97.67%(42/43)。在所有钙化类型中,微钙化多见,占81.99%(214/261),其中恶性结节微钙化占72.41%(189/261),良性结节微钙化占9.58%(25/261);混合钙化共29例,其中恶性结节占65.52%(19/29),良性结节占34.48%(10/29),差异有统计学意义;粗大钙化共15例,其中恶性结节占60.00%(9/15),良性结节占40.00%(6/15);环状钙化仅3例,未作统计学分析。结果表明,微钙化、混合钙化在良恶性结节中的差异有统计学意义,甲状腺良恶性结节中粗大钙化的差异没有统计学意义。结论微钙化高度提示恶性结节,混合钙化提示结节为恶性可能,环状钙化结节多为良性,而粗大钙化不能排除为恶性结节,要明确诊断需结合其他超声显像特点综合分析。
Objective To investigate the diagnostic value of different types of calcification of thyroid for benign and malignant nodules by ultrasonography. Methods Retrospective analysis in our hospital ultrasound showed 261 thyroid nodules with different types of calcification, all nodules have surgical pathology results, observation and analysis of micro-calcification, coarse calcification, calcification and mixed calcification in benign and malignant nodules In the proportion of calcification and benign nodules in the incidence of benign and malignant. Results The incidence of malignant nodules in 261 thyroid calcified nodules was 83.52% (218/261) which was significantly higher than that of benign nodules (16.48%, 43/261), the difference was statistically significant. Malignant calcified nodules accounted for 95.41 % (208/218), nodular goiter in benign calcified nodules accounted for 97.67% (42/43). Of all the calcifications, microcalcifications were common, accounting for 81.99% (214/261), of which malignant nodules (72.41%, 189/261) and benign nodules (9.58%, 25/261) A total of 29 cases of calcification, malignant nodules accounted for 65.52% (19/29), benign nodules accounted for 34.48% (10/29), the difference was statistically significant; coarse calcification in 15 cases, of which malignant nodules accounted for 60.00% ( 9/15), benign nodules accounted for 40.00% (6/15); ring calcification in only 3 cases, no statistical analysis. The results showed that the difference between microcalcification and mixed calcification in benign and malignant nodules was statistically significant. The difference of coarse calcification in benign and malignant thyroid nodules was not statistically significant. Conclusions Micro-calcification is highly suggestive of malignant nodules. Mixed calcification suggests nodules may be malignant. Most of calcified nodules are benign, whereas coarse calcification can not be excluded as malignant nodules. It is necessary to make a comprehensive analysis of the characteristics of other ultrasound imaging combined with definite diagnosis.