Objective To investigate the clinical value of high-frequency ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods A total of 223 cases of thyroid nodule sonographic findings confirmed by pathological examination were retrospectively analyzed,focusing on the analysis of the indexes such as thyroid nodules′internal echo characteristics and the tumor size,shape,aspect ratio, edge,the presence of calcification and so on.Results Of 223 cases of thyroid nodule,68 cases of thyroid cancer,155 cases of benign nodule. 73 cases were thyroid carcinoma in ultrasonic diagnosis in which 58 cases were in accordance with pathological diagnosis, the positive predictive value was 85.3%;155 cases were benign nodules in ultrasonic diagnosis in which 140 cases were in accordance with pathological diagnosis t,he positive predictive value was 90.3%.The sensitivities in the diagnosis of thyroid carcinoma with the condition of hypoechoic and grit-like calcification internal achieved 88.2%and 82.4%,respectively.Higher specificities in the diagnosis of thyroid carcinoma with the condition of nodule aspect ratio greater than or equal to 1,unclear boundary and (or) irregular shape achieved 95.4% and 90.3%, respectively.Conclusion High-frequency ultrasound is of great value in judging benign and malignant thyroid nodules.The conditions of nodule aspect ratio greater than or equal to 1,hypoechoic and grit-like calcification internal,unclear boundary and(or) irregular shape are important indicators in the diagnosis of thyroid malignant neoplasm,with higher diagnostic accuracy.%目的 探讨高频超声检查对甲状腺良恶性结节诊断的临床应用价值. 方法 回顾分析经病理证实的223个甲状腺结节的高频超声表现,分析甲状腺肿块内部回声特点、肿块大小、形态、纵横比、边缘、有无钙化等指标. 结果 223个甲状腺结节中,病理诊断为甲状腺癌68个,良性结节155个;超声诊断为甲状腺癌73个,良性结节150 个;68 个甲状腺癌中,超声诊断恶性病变58个,阳性预测值为85.3%,155个甲状腺良性肿瘤中,超声诊断良性病变140个,阴性预测值为90.3%. 分别以结节内部呈低回声、砂粒样钙化为标准,诊断甲状腺癌的敏感性分别为88.2%和82.4%;以结节纵横比≥1或边界不清和(或)形态不规则为标准,诊断甲状腺癌的特异性较高,分别为95.4%和90.3%. 结论 高频超声检查对鉴别甲状腺结节良恶性具有很高的临床价值;结节纵横比≥1、内部呈低回声、砂粒样钙化、肿块边界不清和(或)形态不规则是诊断甲状腺恶性肿瘤的重指标,具有较高的诊断准确性.
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