| 李盼,李艳艳.超声灰度比值应用于军人单发甲状腺结节定性诊断的价值研究[J].安徽医药,2026,30(10):2019-2023. |
| 超声灰度比值应用于军人单发甲状腺结节定性诊断的价值研究 |
| The value of ultrasound gray-scale ratio in the qualitative diagnosis of solitary thyroid nodules in military personnel |
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| DOI：10.3969/j.issn.1009-6469.2026.10.021 |
| 中文关键词: 甲状腺结节 超声灰度比值 甲状腺结节灰度值 影响因素 鉴别价值 |
| 英文关键词: Thyroid nodule Ultrasound gray-scale ratio Thyroid nodule gray-scale value Influencing factors Discriminative value |
| 基金项目:陕西省重点研发项目( 2017SF-169)；陕西省科技统筹创新工程计划项目( 2016TZC-S-15-12) |
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| 中文摘要: |
| 目的探讨采用超声灰度比值对军人单发甲状腺结节进行良恶性鉴别的临床价值。方法前瞻性研究。纳入 2021年 3月至 2024年 3月于中国人民解放军空军军医大学第一附属医院综合诊疗体检二部通过超声检查发现存在单发甲状腺结节的军人病例共 240例，所有结节均经超声引导下穿刺活检或手术病理学检查获得明确诊断，据此将研究对象分为良性组与恶性组。系统收集病人的基线资料、甲状腺功能相关实验室指标及超声影像参数。采用单因素分析法筛选与结节良恶性相关的潜在因素；进一步通过 logistic回归模型确定独立影响因素；运用受试者操作特征曲线( ROC曲线)评估超声灰度比值及结节灰度值对甲状腺结节性质的判别效能。结果恶性组甲状腺结节灰度值为 41.26±16.72，良性组为 69.56±21.77；恶性组超声灰度比值为 0.54±0.11，良性组为 0.92±0.20，两组均差异有统计学意义(均 P<0.001)。病理诊断结果显示， 240枚结节中良性 165枚(68.75%)包括腺瘤 87例与结节性甲状腺肿 78例；恶性 75枚( 31.25%)以微小乳头状癌为主。单因素分析表明，两组间在结节灰度值和超声灰度比值上差异有统计学意义( P<0.05)。 logistic回归分析证实，结节灰度值［ OR=0.907，95%CI:(0.868，0.948)］与超声灰度比值［OR=0.000，95%CI:(0.000，0.000)］均为鉴别结节性质的有效指标(P<0.05)。此外，超声灰度比值的观察者内及观察者间相关系数分别为 0.953和 0.846，表明其测量一致性良好。结论超声灰度比值与结节灰度值在军人单发甲状腺结节的定性诊断中均具应用价值，其中超声灰度比值诊断准确度更高，可作为健康体检中提示结节性质的有效参考指标。 |
| 英文摘要: |
| Objective To investigate the clinical value of ultrasound gray-scale ratio in differentiating benign from malignant solitary thyroid nodules in military personnel.Methods Prospective study. A total of 240 military cases with solitary thyroid nodules detectedby ultrasound at the Second Department of Comprehensive Physical Examination and Outpatient Care, The First Affiliated Hospital ofPLA Air Force Medical University, from March 2021 to March 2024, were enrolled in this study. All nodules were definitively diag-nosed by ultrasound-guided fine-needle aspiration biopsy or surgical pathology, and the subjects were accordingly divided into benignand malignant groups. Baseline patient data, thyroid function-related laboratory indicators, and ultrasound imaging parameters were sys-tematically collected. Univariate analysis was used to screen for potential factors associated with nodule benignity/malignancy; indepen-dent influencing factors were further identified by logistic regression. Receiver operating characteristic curves (ROC curves) were em-ployed to evaluate the discriminatory performance of ultrasound gray-scale ratio and nodule gray-scale value for thyroid nodule charac-terization.Results The gray-scale values of thyroid nodules were 41.26±16.72 and 69.56±21.77 for the malignant group and the be-nign group, respectively; the ultrasound gray-scale ratio was 0.54±0.11 in the malignant group and 0.92±0.20 in the benign group, withstatistically significant differences between the two groups (both P<0.001). Pathological diagnosis revealed that among the 240 nodules,165 (68.75%) were benign (including 87 adenomas and 78 nodular goiters) and 75 (31.25%) were malignant (predominantly micropapil-lary thyroid carcinoma). Univariate analysis showed significant differences between the two groups in nodule gray-scale value and ultra-sound gray-scale ratio (P<0.05). Logistic regression analysis confirmed that both nodule gray-scale value [OR=0.907, 95%CI: (0.868, 0.948)] and ultrasound gray-scale ratio [OR=0.000, 95%CI: (0.000, 0.000)] were effective indicators for nodule characterization (both P <0.05). Moreover, the intra-observer and inter-observer correlation coefficients for ultrasound gray-scale ratio were 0.953 and 0.846, re-spectively, suggesting good measurement consistency.Conclusion Both ultrasound gray-scale ratio and nodule gray-scale value have application value in the qualitative diagnosis of solitary thyroid nodules in military personnel, with the ultrasound gray-scale ratio show-ing higher diagnostic accuracy and serving as a useful reference indicator for nodule characterization during health check-ups. |
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