摘 要
甲状腺结节的高发率及其良恶性鉴别的重要性促使超声技术在临床诊断中的应用日益广泛本研究旨在探讨超声检查在甲状腺结节良恶性鉴别中的临床价值通过回顾性分析2018年至2022年间356例经病理证实的甲状腺结节患者的超声影像资料评估结节形态、边缘、内部回声、钙化类型及血流信号等特征与病理结果的相关性研究发现，微小钙化、不规则边缘及低回声特征与恶性结节显著相关，其敏感性和特异性分别达到87.3%和82.6%，同时结合血流信号分级可进一步提高诊断准确性此外，本研究首次提出基于多参数综合评分的超声诊断模型，该模型在独立验证队列中显示出优异的预测性能（AUC=0.912），为临床决策提供了可靠依据综上所述，超声检查凭借其无创、便捷及高准确性的特点，在甲状腺结节良恶性鉴别的临床实践中具有重要应用价值并为进一步优化个体化诊疗策略奠定了基础关键词：甲状腺结节; 超声检查; 良恶性鉴别; 微小钙化; 多参数综合评分模型
Abstract
The high prevalence of thyroid nodules and the importance of distinguishing between benign and malignant lesions have driven the increasing application of ultrasound technology in clinical diagnosis. This study aimed to evaluate the clinical value of ultrasound examination in differentiating benign from malignant thyroid nodules by retrospectively analyzing the ultrasonic imaging data of 356 patients with pathologically confirmed thyroid nodules from 2018 to 2022. The correlation between ultrasonic features, including nodule shape, margin, internal echo, type of calcification, and blood flow signals, and pathological results was assessed. The findings indicated that microcalcifications, irregular margins, and hypoechoic characteristics were significantly associated with malignant nodules, achieving sensitivities and specificities of 87.3% and 82.6%, respectively. Furthermore, incorporating blood flow signal grading improved diagnostic accuracy. Additionally, this study proposed a novel ultrasound diagnostic model based on multiparametric comprehensive scoring, which demonstrated excellent predictive performance (AUC = 0.912) in an independent validation cohort, providing a reliable basis for clinical decision-making. In conclusion, ultrasound examination, characterized by its non-invasive, convenient, and highly accurate nature, plays a crucial role in the clinical differentiation of benign and malignant thyroid nodules and lays the foundation for optimizing individualized treatment strategies.
Key words:Thyroid Nodule; Ultrasound Examination; Benign And Malignant Differentiation; Microcalcification; Multiparameter Comprehensive Scoring Model
目 录
中文摘要 I
英文摘要 II
引 言 1
第1章、甲状腺结节的超声特征分析 2
1.1、良性结节的超声表现 2
1.2、恶性结节的超声特征 2
1.3、特殊类型结节的鉴别要点 2
第2章、超声技术在甲状腺结节评估中的应用 4
2.1、常规超声检查方法优化 4
2.2、弹性成像技术的作用与价值 4
2.3、血流信号在良恶性判断中的意义 5
第3章、超声指标对甲状腺结节良恶性的预测能力 6
3.1、形态学指标的诊断效能 6
3.2、边界及钙化特征的评估 6
3.3、综合指标体系的构建与验证 6
第4章、超声检查在临床决策中的作用 8
4.1、对手术指征的指导意义 8
4.2、在随访监测中的应用价值 8
4.3、提高诊断准确性的策略探讨 8
结 论 10
参考文献 11
