| 摘要: |
| 目的 探讨基于超声声像特征和局灶性强回声类型对甲状腺TI-RADS 4类结节良恶性诊断。方法 回顾性分析2018年1月~2020年12月在本医院收治的102例甲状腺TI-RADS 4类结节患者的超声资料。分析甲状腺TI-RADS 4类结节的二维超声特征,对甲状腺结节的局灶性强回声进行分类,通过二元Logistics多因素分析,筛选出能预测甲状腺TI-RADS 4类结节恶性的独立危险因素。结果 102例甲状腺TI-RADS 4类结节患者经病理诊断共检出214个甲状腺结节,包括181个良性结节和33个恶性结节。良恶、性甲状腺TI-RADS 4类结节的二维超声征象在边缘、纵横比、回声等超声征象差异均具统计学意义(P<0.05)。在214个甲状腺结节中,恶性结节中强回声表现为Ⅴ型和Ⅵ型居多,分别为12个(36.36%)和11个(33.33%)；良性结节中表现为Ⅰ型和Ⅱ型较多,分别为98个(54.14%)和59个(32.60%),且良、恶性结节中强回声Ⅰ型、Ⅱ型、Ⅳ型、Ⅴ型和Ⅵ型差异具有显著性(P＜0.05)。二元 Logistic逐步回归分析显示,低回声、纵横比≥1、强回声Ⅳ型、Ⅴ型和Ⅵ型是预测恶性甲状腺结节的独立因素(OR=4.289, 4.051, 3.333, 4.047和4.112,P＜0.05),强回声Ⅰ型、Ⅱ型是预测良性甲状腺结节的独立因素(OR=0.291, 0.305, P＜0.05)。结论 超声声像特征和局灶性强回声类型对于甲状腺TI-RADS 4类结节良恶性诊断有一定参考价值。 |
| 关键词: 甲状腺结节 TI-RADS 4类 超声声像特征 局灶性强回声类型 |
| DOI： |
| 投稿时间：2022-11-20修订日期：2022-11-20 |
| 基金项目:疏肝解郁、软坚散结法治疗甲状腺结节的研究2018478 |
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| Construction of the model for the differential diagnosis of TI-RADS class 4 nodules based on ultrasonographic characteristics and types of focal strong echo |
| hanjuan,zuoyanming,zhangliwen,songjinling,dongjing |
| () |
| Abstract: |
| Objective To explore the differential diagnosis of TI-RADS class 4 nodules based on ultrasonographic characteristics and types of focal strong echo. Methods A retrospective analysis was performed on the ultrasound data of 102 patients with TI-RADS class 4 thyroid nodules admitted to the hospital between January 2018 and December 2020. The two-dimensional ultrasound characteristics of TI-RADS class 4 nodules were analyzed. The focal strong echoes of thyroid nodules were classified. The independent risk factors to predict the malignancy of TI-RADS class 4 thyroid nodules were screened out by binary Logistics multivariate analysis. Results In the 102 patients with TI-RADS class 4 nodules, pathological diagnosis showed that there were 214 thyroid nodules, including 181 benign nodules and 33 malignant nodules. The differences in two-dimensional ultrasound signs (edge, aspect ratio, echo) between benign and malignant thyroid nodules were statistically significant (P<0.05). In malignant nodules, strong echoes of types V and VI were in the majority [12 (36.36%), 11 (33.33%)]. In benign nodules, strong echoes of types I and II were in the majority [98 (54.14%), 59 (32.60%)]. There were significant differences in strong echoes of types I, II, IV, V and VI between benign and malignant nodules (P<0.05). Binary Logistic stepwise regression analysis showed that low echo, aspect ratio ≥1 and strong echoes of types IV, V and VI were independent predictors of malignant thyroid nodules (OR=4.289, 4.051, 3.333, 4.047, 4.112, P<0.05), while strong echoes of types I and II were independent predictors of benign thyroid nodules (OR=0.291, 0.305, P<0.05). Conclusion Ultrasonographic characteristics and types of focal strong echo have certain reference value in the differential diagnosis of benign and malignant TI-RADS class 4 thyroid nodules. |
| Key words: Thyroid nodule TI-RADS class 4 Ultrasonographic characteristic Type of focal strong echo |
