Diagnosis Of Benign And Malignant Thyroid Nodules By Color Doppler Ultrasound And Serum TSH

Objectives To explore the neck color doppler flow imaging(cdfi) combined serum TSH detection in the diagnosis of benign and malignant thyroid nodule.Methods Between January 2011- 2016 January in North China and University Affiliated Hospital, Tangshan worker’s Hospital, people’s Hospital of Tangshan City, Fengrun District People’s hospital hospitalization 1322 cases of thyroid nodules were analyzed retrospectively. All cases were examined by color Doppler ultrasonography and serum TSH before and after operation. The patients were divided into two groups according to the postoperative pathological report of the patients. The patients were divided into benign thyroid nodule group(benign group) and malignant lesion group(malignant group). Malignant group, 485 cases. Among them, 120 were male and 365 were female. Age between 13-69 years old, mean age 41.02±11.05 years old. Benign group, 496 cases. Among them, 102 cases were male and 394 were female. Age 17-79 years old, average age 43.64±11.48 years old. Collected in the two groups of patients with color Doppler ultrasound image characteristics and serum TSH values to obtain the data by SPSS 19.0 software statistical analysis results; non conditional logistic regression model was established using forward stepwise analysis regression analysis.Results 1)The average size of the malignant group was 1.24±1.15 cm, the average size of the benign group was 1.25±1.13 cm. There was no significant difference between the two groups(P >0.05).2)384 Cases of malignant nodules, 101 cases of unclear boundary, 51 cases of clear boundary, 445 cases of benign nodules, cases of clear boundary. The difference between the two groups was statistically significant(P.<0.05).3)Malignant nodules were not regular in 386 cases, 99 cases were regular in shape, 81 cases had irregular shape, 415 cases had regular shape. The difference between the two groups was statistically significant(P <0.05).4)311 cases of malignant nodules group internal low echo, low internal echo 102 people, echo in 15 cases, mixed echo in 57 cases; 16 cases of benign nodules and very low echo, low internal echo 169, echo in 301 cases, mixed echo in 57 cases. The difference between the two groups was statistically significant(P <0.05). Malignant groups were mostly low echo or very low echo, the benign group was more than the echo or mixed echo.5)Group of malignant nodules acoustic halo Bohou uneven 398 cases, 87 cases of homogeneous acoustic halo; benign nodules acoustic halo Bohou uneven 81 cases, acoustic halo uniform 415 cases. The comparison between the two groups, the difference was statistically significant(P <0.05).6)Malignant lesions aspect ratio is more than or equal to 1 451 cases, vertical and horizontal than < 1 for 34 patients; benign nodules aspect ratio is more than or equal to 1 in 13 cases, vertical and horizontal than < 1 for 483 cases. The comparison between the two groups, the difference was statistically significant(P<0.05).7)And malignant nodule group internal micro calcification(<0.1mm, 129 cases), micro calcifications with coarse calcification(0.1-0.5mm) 313 cases without calcification in 43 cases, 4 cases of benign nodules calcification(<0.1mm), micro calcification combined with coarse calcification(0.1-0.5mm) in 3 cases and no calcification 489. The comparison between the two groups, the difference was statistically significant(P<0.05). Malignant group mostly micro calcification and calcification with coarse calcium, benign group no calcification.8)And malignant nodules vascular pattern without vascular 1 cases, 3 cases of vascular edge, 403 cases of central vascular, 78 cases of mixed vascular; benign nodules vascular pattern without vascular 305 cases, 76 cases of vascular edge, central blood vessels in 5 cases, mixed vascular in 10 cases. The comparison between the two groups, the difference was statistically significant(P <0.05).9)And 2 cases of Grade 10 and malignant nodule group blood flow distribution, and the distribution of blood flow grade 1 in 5 cases, blood flow distribution and 161 cases of grade 2, vascular distribution of 317 cases of grade 3; 0 304 cases of benign nodules flow distribution, distribution of blood flow in 176 cases of grade 1, distribution of blood flow grade 2 in 1 case, vascular distribution and 9 cases of grade 3. The difference between the two groups was statistically significant(P <0.05).10)There were 327 cases with abnormal lymph nodes in the neck of the malignant group, 128 cases with no structural abnormalities, 38 cases with abnormal cervical lymph nodes and 458 cases with no structural abnormalities. The difference between the two groups was statistically significant(P <0.05).11)462 cases of malignant group serum TSH value is lower than the normal level in 11 cases, at the normal level of 187 cases, higher than normal levels of 287 cases; Liang group serum TSH values below the normal level 31, at normal levels, higher than the normal level in 3 cases. Chi square test results show that the higher than normal levels for the malignant, and the difference is statistically significance(P <0.05); lower than normal levels of the benign group than in the malignant group, the difference is significant statistical significance(P <0.05).12)Non conditional Logistic regression model forward stepwise regression analysis showed that the blood flow distribution increased with the increase of the blood flow, the risk factors increased exponentially; the serum TSH increased with the increase of the value, the risk factors also increased exponentially. The difference was statistically significant(P < 0.05).Conclusions Color doppler ultrasound images show irregular nodule boundary is not clear, form, internal low echo or low echo, acoustic halo uneven, aspect ratio 1 or higher, microcalcification merge within coarse calcification, a central blood vessel, blood flow distribution level 3, the structure of the cervical lymph nodes appear abnormal thyroid nodule enough, when the probability. The serum level of TSH in malignant group was higher than that in benign group, which showed that the high serum TSH level was the risk factor for the nodule worsening. The distribution of blood flow classification, risk factors in malignant thyroid nodules in the highest serum TSH, a diagnosis of malignant thyroid nodules.