Differentiation of benign and malignant thyroid nodules by ultrasonography

doi:10.3877/cma.j.issn.1674-0793.2017.02.013

Abstract

Abstract:

Objective

To explore the value of ultrasound in the diagnosis of benign and malignant thyroid nodules.

Methods

From February 2015 to March 2016, eighty nine cases with 131 thyroid nodules were treated in Huangshi Central Hospital and underwent gray-scale ultrasound and color doppler ultrasound. The sonographic features of benign and malignant nodules were compared.

Results

In the 131 nodules, 72 nodules were benign, and 59 were malignant; benign nodules were mainly follicular hyperplasia (83.33%), and malignant nodules were mainly papillary carcinoma (88.14%). There were statistically significant differences in morphology, boundary, posterior attenuation and calcification characteristics between benign and malignant nodules ( χ²=9.133, 13.384, 15.782, 15.728, 8.285, all P<0.01), while no significant difference in internal echo. There were statistically significant differences in ring blood flow, perforating blood flow, branch situation, running situation, and the resistance index ( χ²=9.133, 13.384, 15.782, 15.728, 8.285, all P<0.01), while no significant difference in the richness degree of blood flow. The sensitivity of gray-scale ultrasound in detecting malignant nodules was 67.80%, the specificity was 73.61%, the positive predictive value was 67.80%, the negative predictive value was 73.61%. The sensitivity of Color Doppler ultrasound was 73.47%, specificity was 73.61%, positive predictive value was 65.45%, negative predictive value was 80.30%. The sensitivity of gray scale ultrasound + color Doppler ultrasound was 74.58%, the specificity was 87.50%, the positive predictive value was 83.02%, the negative predictive value was 80.77%.

Conclusion

Ultrasonic standardization inspection has good application value in the diagnosis of benign and malignant thyroid nodules, and the gray scale ultrasonography combined with color Doppler ultrasound diagnostic is worthy of clinical application.

Key words: Ultrasonography, Thyroid nodule, Diagnosis, differential, Benign, Malignant

Xunbi Liu, Guoxi Huang, Gangsheng Wang. Differentiation of benign and malignant thyroid nodules by ultrasonography[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(02): 119-122.

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结节	个数	形态		边界		内部回声高低
结节	个数	规则	不规则	清晰	不清晰	高回声	中等回声	低回声
良性	72	61（84.72)	11（15.28)	52（72.22)	20（27.78)	13（18.06)	21（29.17)	38（52.78)
恶性	59	21（35.59)	38（64.41)	20（33.9)	39（66.10)	10（16.95)	17（28.81)	32（54.24)
χ²值		33.429		19.240		0.037
P值		0.000		0.000		0.982
结节	个数	内部回声均匀度		后方衰减		钙化
结节	个数	均匀	不均匀	有	无	无	沙粒样	粗大钙化
良性	72	39（54.17)	33（45.83)	12（16.67)	60（83.33)	34（47.22)	1（1.39)	37（51.39)
恶性	59	27（45.76)	32（54.24)	32（54.24)	27（45.76)	13（22.03)	34（57.63)	12（20.34)
χ²值		0.916		20.520		52.479
P值		0.338		0.000		0.000

结节	个数	形态		边界		内部回声高低
结节	个数	规则	不规则	清晰	不清晰	高回声	中等回声	低回声
良性	72	61（84.72)	11（15.28)	52（72.22)	20（27.78)	13（18.06)	21（29.17)	38（52.78)
恶性	59	21（35.59)	38（64.41)	20（33.9)	39（66.10)	10（16.95)	17（28.81)	32（54.24)
χ²值		33.429		19.240		0.037
P值		0.000		0.000		0.982
结节	个数	内部回声均匀度		后方衰减		钙化
结节	个数	均匀	不均匀	有	无	无	沙粒样	粗大钙化
良性	72	39（54.17)	33（45.83)	12（16.67)	60（83.33)	34（47.22)	1（1.39)	37（51.39)
恶性	59	27（45.76)	32（54.24)	32（54.24)	27（45.76)	13（22.03)	34（57.63)	12（20.34)
χ²值		0.916		20.520		52.479
P值		0.338		0.000		0.000

结节	个数	丰富程度		环状血流		穿支血流
结节	个数	少血供	富血供	有	无	有	无
良性	72	32（44.44)	40（55.56)	37（51.39)	35（48.61)	21（29.17)	51（70.83)
恶性	59	29（49.15)	30（50.85)	15（25.42)	44（74.58)	36（61.02)	23（38.98)
χ²值		0.289		9.133		13.384
P值		0.591		0.000		0.000
结节	个数	分支情况		走形情况		RI
结节	个数	点线状	分支状	扭曲	较平直	>0.7	<0.7
良性	72	55（76.39)	17（23.61)	15（20.83)	57（79.17)	19（26.39)	53（73.61)
恶性	59	25（42.37)	34（57.63)	32（54.24)	27（45.76)	30（50.85)	29（49.15)
χ²值		15.782		15.728		8.285
P值		0.000		0.000		0.000

结节	个数	丰富程度		环状血流		穿支血流
结节	个数	少血供	富血供	有	无	有	无
良性	72	32（44.44)	40（55.56)	37（51.39)	35（48.61)	21（29.17)	51（70.83)
恶性	59	29（49.15)	30（50.85)	15（25.42)	44（74.58)	36（61.02)	23（38.98)
χ²值		0.289		9.133		13.384
P值		0.591		0.000		0.000
结节	个数	分支情况		走形情况		RI
结节	个数	点线状	分支状	扭曲	较平直	>0.7	<0.7
良性	72	55（76.39)	17（23.61)	15（20.83)	57（79.17)	19（26.39)	53（73.61)
恶性	59	25（42.37)	34（57.63)	32（54.24)	27（45.76)	30（50.85)	29（49.15)
χ²值		15.782		15.728		8.285
P值		0.000		0.000		0.000

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