彭贵平 李智惠 陈紫剑 徐素音

[摘要] 目的 探討甲状腺结节钙化的超声影像特征在甲状腺癌诊断中的临床应用效果。 方法 选择2019年3月至2020年3月间我院收治的60例甲状腺结节患者作为研究对象，均给予彩色多普勒超声、病理检查，以病理检查为“金标准”，并根据病理结果进行分组，甲状腺良性疾病的归为对照组（n=35），甲状腺癌的归为观察组（n=25）。比较两组超声下结节钙化检出率，分析两组的结节钙化特征、诊断效能等情况。 结果 经病理检查结果显示，25例甲状腺癌患者有14例出现结节钙化情况。结节钙化超声影像在甲状腺癌钙化中的灵敏度为92.86%，特异度为90.91%，阳性预测值为92.86%，阴性预测值为90.91%，误诊率为9.09%，漏诊率为7.14%，诊断符合率为92.00%，诊断价值较高;观察组的结节钙化检出率高于对照组（P<0.05）;观察组的钙化结节边界不清晰发生率、微钙化发生率、单个结节发生率均明显高于对照组（P<0.05）;乳头状癌、滤泡性癌的微钙化发生率均高于粗钙化发生率（P<0.05），而髓样癌、未分化癌的微钙化与粗钙化发生率相比，差异无统计学意义（P>0.05）。 结论 甲状腺结节钙化的超声影像特征在甲状腺癌诊断中有较高价值。

[关键词] 甲状腺结节;钙化;超声影像特征;甲状腺癌

[中图分类号] R736.1          [文献标识码] B          [文章编号] 1673-9701（2021）36-0105-04

The clinical application of ultrasound imaging characteristics of thyroid nodule calcification in the diagnosis of thyroid cancer

PENG Guiping   LI Zhihui   CHEN Zijian   XU Suyin

Department of Ultrasonography， Jiujiang NO.1 People’s Hospital in Jiangxi Province， Jiujiang   332000， China

[Abstract] Objective To investigate the clinical application effect of ultrasound imaging characteristics of thyroid nodule calcification in the diagnosis of thyroid cancer. Methods From March 2019 to March 2020， 60 patients with thyroid nodules who were admitted to our hospital were selected as the study subjects， and they were all given color Doppler ultrasound and pathological examinations. The pathological examination was taken as the "gold standard" and the patients were grouped according to the pathological results. Benign thyroid diseases were assigned in the control group （n=35）; thyroid cancer was assigned in the observation group （n=25）. The detection rate of nodular calcification under ultrasound was compared between the two groups， and the characteristics of nodular calcification and diagnostic efficiency were analyzed in both groups. Results The results of pathological examination showed that 14 out of 25 patients with thyroid cancer had nodular calcification. The sensitivity of nodular calcification ultrasound imaging in thyroid cancer was 92.86%， the specificity was 90.91%， the positive predictive value was 92.86%， the negative predictive value was 90.91%， the misdiagnosis rate was 9.09%， the missed diagnosis rate was 7.14%， and the diagnosis coincidence rate was 92.00%. The diagnostic value was relatively high; the detection rate of nodule calcification in the observation group was higher than that in the control group （P<0.05）; the incidence of unclear boundaries of calcified nodules， microcalcifications， and single nodules in the observation group were significantly higher than those in the control group （P<0.05）; the incidence of microcalcification in papillary carcinoma and follicular carcinoma was higher than the incidence of coarse calcification （P<0.05）. However， there was no statistically significant difference in the incidence of microcalcification and coarse calcification in medullary carcinoma and undifferentiated carcinoma （P>0.05）. Conclusion The ultrasound imaging characteristics of thyroid nodule calcification are of a high value in the diagnosis of thyroid cancer.

[Key words] Thyroid nodules; Calcification; Ultrasound imaging characteristics; Thyroid cancer

甲状腺结节可分为良性结节和恶性结节，其中，恶性结节绝大部分为甲状腺癌。甲状腺癌属于临床较为常见的恶性肿瘤，病灶部位通常在甲状腺腺体中，随着人们的生活方式的不断改变，甲状腺癌的发病率逐年攀升，且呈现年轻化趋势[1]。……