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目的探讨超声检查在鉴别微小结节性甲状腺肿与甲状腺微小乳头状癌患者中的应用价值。方法选取2014年1月至2016年1月大连市第三人民医院收治的88例甲状腺微小结节患者作为研究对象,按照病理结果将其分为观察组与对照组,各44例。观察组为甲状腺微小乳头状癌患者(共60个结节),对照组为微小结节性甲状腺肿患者(共74个结节)。所有患者均行超声检查,观察其超声图像特点,分析超声诊断价值。结果观察组患者结节形态不规则、边界模糊、回声呈低回声、单发、微钙化比例均明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者的动脉收缩期峰值速度、阻力指数均明显大于对照组,差异均有统计学意义(均P<0.05);观察组患者的超声检出率为100.0%(44/44),明显高于对照组的81.8%(36/44),差异有统计学意义(χ2=12.68,P=0.000)。结论超声检查能提升微小结节性甲状腺肿及甲状腺微小乳头状癌鉴别诊断的准确性,避免出现误诊、漏诊。
Objective To investigate the value of ultrasonography in the differential diagnosis of small nodular goiter and thyroid papillary carcinoma. Methods A total of 88 patients with thyroid nodules admitted from the Third People ’s Hospital of Dalian City from January 2014 to January 2016 were selected for the study. According to the pathological findings, they were divided into the observation group and the control group, with 44 cases in each group. The observation group was a patient with small thyroid papillary carcinoma (60 nodules in all) and the control group was a patient with a small nodular goiter (74 nodules in total). All patients underwent ultrasound examination to observe the characteristics of ultrasound images, the value of diagnostic ultrasound. Results The observation group had irregular nodules, fuzzy boundaries and hypoechoic echoes. The rates of solitary and microcalcifications in the observation group were significantly higher than those in the control group (all P <0.05). In the observation group, the arteries were contracted (P <0.05). The detection rate of ultrasonography in the observation group was 100.0% (44/44), which was significantly higher than that in the control group (81.8%), and the peak velocity and resistance index of the observation group were significantly higher than that of the control group (36/44), the difference was statistically significant (χ2 = 12.68, P = 0.000). Conclusion Ultrasonography can improve the accuracy of differential diagnosis of small nodular goiter and small papillary thyroid carcinoma to avoid misdiagnosis and missed diagnosis.