To Explore The Value Of Ultrasound In Differential Diagnosis Of Thyroid Nodules

BackgroundThyroid nodules are the masses of thyroid with abnormal hardness and structure.Thyroid nodule in the endocrine system is a frequently encountered andcommonly-seen disease. Most thyroid nodules are benign lesions. The majority ofthe benign nodules need to review on a regular basis.The malignant thyroid nodulesshould be treated as soon as possible. So it improves the prognosis. The diagnosis ofbenign and malignant thyroid nodule is the first problem of identification, so as toearly detection of thyroid cancer nodules and treatment. With the development ofdiagnostic technology and the application of many advanced diagnostic tools, suchas18F-FDG-PET, three-dimensional ultrasound and so on, it provides a newthought of diagnosis. And ultrasound examination is still the preferred apparatus inthe diagnosis of thyroid nodule because of its non-invasive, convenient and quick, noradioactive and low cost. This study is to investigate the value of ultrasonography indifferential diagnosis of thyroid nodules.PurposeThrough the analysis of the ultrasonic examination results of patients withthyroid nodules and pathological examination results, the study explored the value ofultrasonography in differential diagnosis of thyroid nodules. Materials and methodsIt collected the ultrasonic examination results， postoperative pathologicexamination results and clinical data of628cases of patients with thyroid nodule.Then it analyzed retrospectively them. The patients accepted the general surgeryfrom January2010to January2013in the Second Affiliated Hospital of ZhengzhouUniversity. Their age distribution is14-85years old. And the average age is48.05±13.50years old. There are129cases of male patients. There are499cases offemale patients. The Ratio is0.26:1. Patients are examined by high resolutionultrasound and color doppler ultrasound. It collected the number of thyroid nodules,the echo level, boundary, edge, capsular, halo, calcification, the blood flow andelastogram scores. According to the results of postoperative pathologic examination,we established the Logistic model of two classification. We used SPSS software toanalysis the value of ultrasonography in differential diagnosis of thyroid nodules.ResultsPut the number of thyroid nodules, the echo level, boundary, edge, capsular,halo,calcification, the blood flow and elastogram scores to carry on the chi squaretest. There was no statistical significance in the number of nodules（P＞0.05）.Andthere was statistical significance in the rest of the ultrasonic signs（P＜0.05）.Byestablishing a Logistic regression model， spiculated margin, calcifications,hypoechogenicity,capsular invasion were elected to differentiate benign andmalignant thyroid nodules. It use elastogram scores≥3（OR=20.892，r=2.873，P=0.000）, spiculated margin（OR=19.494，r=2.570，P=0.000）, calcifications（OR=16.421，r=2.351，P=0.001）, hypoechogenicity（OR=12.533，r=2.296，P=0.000）, capsular invasion（OR=3.861，r=1.351， P=0.009）as the independentvariables of the regression equation of the Logistic regression. Logit(P)=0.783＋1.351X51＋2.570X41＋2.296X22＋2.351X71＋2.873X91, The likelihood ratio testwas used to evaluate the model. The result was statistically significant (χ2=168.112，P=0.000).The model was statistically significant. Through drew the ROC curve.Andthe area under the curve is0.812.Conclusion1. The number of thyroid nodule has no value to differentiate benign and malignant thyroid nodules.2.Logistic regression model selected elastogram scores≥3,spiculated margin, calcifications, hypoechogenicity, capsular invasion to differentiatebenign and malignant thyroid nodules.3.Their diagnosis value arranged from high tolow is: elastogram scores＞spiculated margin＞calcifications＞hypoechogenicity＞capsular invasion.