An Exploration Into The Appraisal On The Nature Of Thyroid Nodules With B Ultrasonic Images And Fine Needle Aspiration Biopsy

Objective:To explore the clinical significance of single and combined applications of preoperative B-ultrasonic indexes in identifying thyroid benign and malignant nodules,and the value of combination of B-ultrasonic and fine needle aspiration biopsy(FNA)in improving the correctness of diagnosis of benign and malignant nodules,and application options of combination of B-ultrasonic and FNA.Methods:Collected the pathological files of 228 thyroid cancer patients and 275 patients of thyroid benign nodules,and their available preoperative B ultrasonic files fiom southern branch of Shanghai General Hospital dating from January,2013 to February,2015,which were verified by the postoperative pathology of thyroid breast surgery.The files were classified according to final postoperative pathology and the result indicated 461 benign nodules and 244 malignant nodules.Made a retrospective analysis on the different indexes of preoperative B ultrasonic of these thyroid nodules(including nodule margin,shape,accompanied calcification,blood flow and echoes);explored the clinical significance of postoperative B ultrasonic to identification of thyroid benign and malignant nodules from single index and combination of indexes;collected the FNA results of patients before operation in that period and found that there were 169 malignant nodules and 172 benign nodules.Basic on the specific characteristics of B ultrasonic,explored how to put FNA to reasonable applications.Result:Maximum diameter mean value of 244 malignant nodules is smaller than that of 461 benign nodules[(10.57±7.62)mm vs(18.94±13.70)mm,t=8.75,P<0.01];benign nodules have larger aspect ratios(0.85±0.29 vs 0.68±0.32,t=6.81,P<0.05)and the difference is of statistical significance;obscure boundary(?2=61.918,P=0.000),irregular shapes(?2=62.749,P=0.000),accompanied calcification(?2=37.355,P=0.000)and low echo(?2=47.704.P=0.000)shown in B ultrasonic images is valuable to identify benign and malignant nodules.The analytical result of preoperative FNA in that period shows that when]72 benign nodules and 169 malignant nodules respectively meet part of or all 4 malignant characteristics(low echo,obscure boundary,irregular shape and accompanied calcification),the possibility of malignant thyroid nodules is respectively 35.59%,49.56%,78.56%and 95.08%,and the accuracy of FNA is respectively 76.32%,91.07%,89.09%and 100%.Conclusion:when B ultrasonic result of thyroid nodule hints aspect ratio>0.8,the possibility of malignant nodules should be considered.Nodules of Irregular shapes,obscure boundary,accompanied calcification and low echo tend to be diagnosed as being malignant.Combination of multiple indexes may improve the accuracy of diagnosis.Meanwhile,according to the number of abnormal characteristics of B ultrasonic inspection results,we can classify the possibilities of thyroid malignant nodules and selectively combine B ultrasonic and FNA to improve the detection ratio of malignant nodules and avoid unnecessary surgical biopsy.