The Analysis Of The Ultrasonographic Features For Benign And Malignant Thyroid Nodules

Objective To analyze of ultrasonographic features in benign and malignant thyroid nodules,and evaluate it in the differential diagnosis of benign and malignant nodules in the role of.Methods The ultrasonographic data of 65 patients with benign and malignant confirmed by pathology from December 2013 to September 2014 in the First Affiliated Hospital of Shihezi University of Xinjiang Province were retrospectively analyzed,and to compare the ultrasonographic features of benign with malignant thyroid nodules.χ2 test was used to detect the correlation among ultrasonographic features of benign with malignant thyroid nodules.Results 1.There were 96 thyroid nodules diagnosed by pathology after surgical operation in the 65 patients.There were 69 nodular goiter(93.2%) which 42 nodular goiter with saccate diversification(60.9%),10 with circumscribed hashimoto’s thyroiditis(14.5%),8 with thyroid adenoma(11.6%),4thyroid adenoma(5.4%),1 thyrolingual cyst(1.4%)in the 74 benign nodules.There were 11 patients with benign pathological changes simultaneously which were 5 with nodular goiter(45.5%),with 4circumscribed hashimoto’s thyroiditis(36.4%),2 with thyroid adenoma(18.2%)in the 22 malignant nodules,whose pathological type were mainly papillary thyroid carcinoma.Among the 96 thyroid nodules,cervical lymph node enlargement were not discovered in the benign nodules,but 5 thyroid cancer with cervical lymph node metastasis(22.7%) in the malignant nodules,and 2 lymph nodes with calcificationare diagnosed by pathology after surgical operation.2.There were 5 thyroid microcancers diagnosed by pathology after surgical operation,and its histological type was papillary thyroid carcinoma, the diameter was 0.3~0.6cm,with benign pathological changes simultaneously which were nodular goiter,thyroid adenoma,and hashimoto’s thyroiditis.There were 2thyroid nodules diagnosed by ultrasonic,besides,3 thyroid nodules were misdiagnosed to benign lesion by pathology after surgical operation.There were 7 benign nodular misdiagnosed as malignant thyroid,in addition,1 thyrolingual cyst misdiagnosed as nodular goiter in the misdiagnosis case.The misdiagnosis and the missed diagnosis rate,were 9.5% and 13.6% respectively.3.The common ultrasonographic features of malignant nodules included illdefined margins(77.3%),solid and hypoechoic texture(68.2%),microcalcifications(63.6%),posterior echo attenuation(59.1%);CDFI :irregular vessel shape,and Internal blood wasⅡrank orⅢrank(68.2%).4.4.With all the ultrasonographic features mentioned above,the sesensitivity 、 specificity and agreement rate of the ultrasonography in diagnosing benign and malignant nodules of thyroid were 86.4%、90.5%、89.6% respectively.5.The features that was border,membrane,anteroposterior to transverse diameter ratio(A/T), internal echoes and structure, microcalcifications, posterior echo attenuation,and blood flow systematics, resistance index(RI) in the differential diagnosis of benign and malignant nodules was extraordinary,it also was significant difference(P<0.05).while the difference of benign and malignant thyroid nodules shape,acoustic halo, arterial peak systolic velocity(PSV) was no statistically significant(P>0.05).Conclusion 1.The significant features to differentiate malignant from benign were border,membrane,anteroposterior to transverse diameter ratio(A/T),internal echoes and structure,microcalcifications,posterior echo attenuation,internal blood flow systematic.2.Ultrasound is a very effective inspection methods in diagnosis of thyroid nodules,and ultrasound in the differential diagnosis of benign and malignant thyroid nodules plays an important role in clinical diagnosis.