Discussion For The Value Of Identify Thyroid Microcarcinoma By Radial Line Characteristic Of Nodules

Objective：Thyroid nodule is one of high popular diseases of threaten people mindand body health nowadays. The surgical cases of thyroid nodules are allincreasing,no matter benign or malignant nodules.Thyroid microcarcinomamay invade to neck lymph early phase. Thus,the identification ofbenign-malignant of thyroid nodules early stage has quite significance for thechoice of treatment plans and the melioration prognosis.The study is discussionabout the correlation of radial line characteristic thyroid little nodules(the majordiameter of nodules≤10mm） and the nature benign-malignant of its, andcompare to the traditional ways identify the nature benign-malignant of thyroidnodules.Set the best way of forepart examination for thyroid microcarcinoma.improve the accuracy of diagnosis of high-frequency ultrasonographic for thethyroid microcarcinoma.Methods：From July2006through March2011, A total of237patients (164women,73men；age17to81,mean age,46.5years±12.8) with436thyroid littlenodules (the major diameter of nodules≤10mm，204malignant，461benign)that had undergone thyroid ultrasonography at our affiliated hospitals and werepathologic diagnosed were included in this study. We retrospective analyseanteroposterior diameter and transverse diameter of nodules and compare to thelengh its. Record separatel the benign-malignant of nodules for anteroposteriordiameter≥transverse diameter and anteroposterior diameter＜transversediameter,and record the other image characteristics of thyroid little nodules:Whether the shape is regulation or not,whether edge is clear or not and the echo characteristic of nodules the microcalcification and aureoleand,thecentral and perimeter vascularity.All patients had undergone thyroid ultrasonography in GE Logiq7, whichlinear array probe,frequency10MHz, resolution1-2mm before surgicaloperation. Patients dorsal decubitus, head hypsokinesis,that undergone thyroidultrasonic examination in2D and CDFI. All nodules examined had thecharacteristics on US images: nodule size, shape, margin, echogenicity, andpresence of microcalcification, vascularity,halo and had the thyroid littlenodules transverse section and vertical section Ultrasound images that isparallel to the three dimensional cross-sectiona and vertical sectiona of thehuman body for standard mearsure the transverse diameter and anteroposteriordiameter of nodules. For avoid the otherness of measure and observe，allpatients had undergone thyroid ultrasonography in one examined roon and oneexperienced doc tor.The comparability of every Ultrasound images characteristic of thyrodbenign-malignant little nodules by χ2test，Statistically significant is P＜0.05.For the correlational differential points comparative analysis by receiveroperating characteristic‐ROC curve. Every Ultrasound images characteristic ofthyrod little nodules for the diagnostic accuracy for thyroid malignant littlenodules by sensitivity,specificity,positive and negative predictive values andaccuracy were obtained.Statistical analysis was performed by using a SPSS13.0statistics software package.Results：（1）The characteristic of ultrasonic images of the anteroposterior diameterare greater or equal to the transverse diameter of nodules shows comparativelyhigh sensitivity，specificity and accuracy（91.8%，96.8%，96.2%）for malignantnodules，compared to the other characteristics which showed very marked difference for the benign-malignant nodules(P<0.001).（2）The characteristic of ultrasonic images of marked hypoechogenicityshowed also very marked difference for the benign-malignant nodules(P<0.001).But the sensitivity，specificity and accuracy are all low to the radialline characteristic of nodules for that(71.7%，88.5%，81.4%）.（3）The characteristic of hypoechogenicity showed also marked differ-ence for the benign-malignant nodules(P<0.001).But the sensitivity，specificityand accuracy are all low（24.5%，19.4%，21.6%）.（4）The characteristics of microcalcification and central vascularity innodules had very high specificity（82.1%，92.5%）but low sensitivity（20.1%，9.2%）.The accuracy are also low（56.0%，57.3%）,which show no markeddifference for the diagnosis of benign-malignant nodules（P＞0.05）.（5）The characteristics of shape margin and hale which show all nomarked difference for the diagnosis of benign-malignant nodules（P＞0.05）.Conclusions：From the results for the conclusions：（1）The radial line characteristic of thyroid noudules on cross section，the anteroposterior diameter are greater or equal to the transverse diameter ofnodules， which shows very marked superiority compared to the othercharacteristics，may act the guideline of diagnose thyroid microcarcinoma byhigh-frequency Ultrasound.（2） Microcalcification and central vascularity in nodules whichspecificity are high but low sensitivity for thyroid microcarcinoma.（3）The characteristics of ultrasonic images of shape margin and halewhose accuracy are low for the diagnoses of thyroid microcarcinoma on early. （4）The characteristic of marked hypoechogenicity and hypoechogenicityof thyroid noudles benefit the early diagnoses of thyroid microcarcinoma.Marked hypoechogenicity has obvious value compare to hypoechogenicity.Butthe diagnostic accuracy for thyroid microcarcinoma on early are all lowcompared to the radial line characteristic of nodules.