The Discussion Of The Diagnosis Value Of Conventional Ultrasonic Indicators On Benign And Malignant Thyroid Nodules

Objective: To analysis the diagnosis value of two-dimensional ultrasonic indicators on benign and malignant thyroid nodules by comparison with pathological results.To provide a basis for the correct clinical decision.Methods: 2013 thyroid nodules removed by surgery and diagnosed pathologically were analyzed retrospectively from January 2011 to April 2016. 414 nodules were benign, 1599 nodules were malignant. There were 9 two-dimensional ultrasonic indicators were collected, including shape, border, margin, echo ratio(compared with jugular anterior fascicles), aspect ratio, internal structure, acoustic halo, posterior attenuation and calcification, a total of 10 indicators with age. To evaluate the sensitivity, specificity and accuracy of every indicator to diagnosis thyroid nodules.To collect 407 pouch mixed nodules and to analysis ultrasonic indicator with Fisher test. P=0.05 considered to indicate significance. Aspect ratio, shape, border, margin,and the echo, bias, calcification in solid part of the pouch mixed nodules, analyzing the differences of the above indicators between benign and malignant groups.Results: There were 414 benign nodules, including 256 nodular goiter, 126 thyrophyma, 10 hyperplastic nodule, 7 hashimoto nodules, 7 follicular hyperplasia nodules, 4 fibrosis nodules, 4 granulation tumor. There were 1599 malignant nodules,including 1445 thyroid papillary carcinoma, 86 follicular carcinoma of thyroid, 31 medullary carcinoma, 15 poorly differentiated carcinoma, 11 hashimoto's disease to cancer, 7 lymphoma, 4 metastatic carcinoma. We did statistical analysis on the 11 ultrasonic characteristics of thyroid nodules respectively. The results were that:acoustic halo?internal structure?shape had high sensitivity,there were 94.93%?92.43%?84.55%,and the specificity were 8.21%?69.08%?59.18%. Posterior echo attenuation?margin and aspect ratio, the three indicators had high specificity, there were 93.24%?83.33%?79.23%. Internal structure?shape?acoustic halo, the predicting accuracy were 87.63%?79.33%?77.10%.407 pouch mixed nodules, there were 286 benign nodules, including 162 nodular goiter, 110 thyrophyma, 10 follicular hyperplasia nodules, 2 hashimoto nodules, 2 hyperplastic nodule. There were 121 malignant nodules, including 114 papillary carcinoma, 6 follicular carcinoma, 1 medullary carcinoma. Fisher test results show that: P=0.05,these indicatiors had significant difference between benign and malignant groups,including aspect ratio?1?irregular shape?obscure boundary?rough edge?the solid part of the pouch mixed nodules was hypoecho?calcification?but bias had no significant difference.Conclusion: Judging thyroid nodules benign or malignant use a single two-dimensional ultrosonic indicator was not accurately, especially high weight indicatiorss like aspect ratic?1 and hypoecho . A complete and comprehensive use was necessary for finally judgment, at least 10 indicators. At the same time, to the pouch mixed nodules, the echo and calcification of the solid part were worth more attention. For those nodules to judge difficulty, FNA could diagnosis early.