【摘要】：目的 :探討超聲在2.0~4.0 mm甲狀腺良、惡性微小結(jié)節(jié)鑒別診斷中的價值。方法 :回顧分析經(jīng)手術(shù)及病理證實(shí)的359例共412枚最大徑在2.0~4.0 mm甲狀腺微小結(jié)節(jié)的超聲資料,其中甲狀腺微小乳頭狀癌(PTMC)173例共194枚,微小結(jié)節(jié)性甲狀腺腫(MNG)179例共204枚,PTMC合并MNG 7例共PTMC 7枚和MNG 7枚,觀察結(jié)節(jié)形態(tài)不規(guī)則、低回聲、縱橫比≥1和微鈣化在PTMC和MNG中的分布。結(jié)果:結(jié)節(jié)形態(tài)不規(guī)則(χ~2=261.967,P0.05)、低回聲(χ~2=17.259,P0.05)、縱橫比≥1(χ~2=249.703,P0.05)在2.0~4.0 mm PTMC與MNG中均具有統(tǒng)計(jì)學(xué)差異,微鈣化無統(tǒng)計(jì)學(xué)差異(χ~2=1.155,P0.05)�？v橫比≥1的特異度(92.9%)、陽性預(yù)測值(91.9%)、準(zhǔn)確度(88.8%)均最高,形態(tài)不規(guī)則陰性預(yù)測值最高(94.4%),低回聲的敏感度(97.0%)最高,其特異度(14.7%)最低。結(jié)論:在2.0~4.0 mm PTMC和MNG的鑒別診斷中,形態(tài)不規(guī)則和縱橫比≥1是兩個重要征象,盡管低回聲對PTMC具有高度的敏感度,但特異度低而限制其臨床應(yīng)用。
[Abstract]:Objective: to evaluate the value of ultrasonography in differential diagnosis of benign and malignant thyroid nodules at 2.0 ~ 4.0 mm. Methods: the ultrasonographic data of 412 thyroid nodules with the maximum diameter of 2.0 ~ 4.0 mm confirmed by surgery and pathology were retrospectively analyzed, including 194 (PTMC) in 173 cases of thyroid micropapillary carcinoma. There were 204 (MNG) in 179 cases of minimal nodular goiter, 7 PTMC and 7 MNG in 7 cases of PTMC combined with MNG. The distribution of irregular shape, low echo, aspect ratio 鈮，

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