摘要目的 超声评估甲状腺结节纵横比(A/T)≥1时诊断甲状腺微小癌的价值.方法 收集2011至2012年在天津医科大学肿瘤医院手术治疗的甲状腺结节患者491例,共683个结节,术前超声测量最大横切面纵横径,分析A/T≥1诊断甲状腺癌的灵敏度和特异度.根据甲状腺癌最大径将结节分为两组,第一组甲状腺癌＞1cm,第二组甲状腺癌≤1cm即甲状腺微小癌,分析A/T≥1在两组甲状腺癌分布差异,并通过SPSS 17.0软件进行统计分析.结果 683个甲状腺结节均经病理证实,良性结节184个,恶性结节499个.499个甲状腺癌中,307个(61.5％)A/T≥1,192个(38.5％)A/T＜1；184个甲状腺良性结节中,29个(15.8％)A/T≥1,155个(84.2％) A/T＜1,差异有统计学意义,P=0.000.499个甲状腺癌中,233个甲状腺癌结节＞1 cm,其中132个(56.7％) A/T≥1,101个(43.3％)A/T＜1；266个甲状腺微小癌中,175个(65.8％) A/T≥1,91个(34.2％) A/T＜1,A/T≥1在甲状腺微小癌和＞1cm甲状腺癌分布差异有统计学意义,x2=4.380,P=0.036.结论 A/T≥1是一项诊断甲状腺癌尤其是甲状腺微小癌的超声特征,其应用可以提高甲状腺微小癌检出率.

abstractsObjective To explore the diagnostic value of thyroid microcarcinoma with a taller-thanwide shape (A/T ≥ 1) in transverse ultrasonographic planes.Methods There were a total of 683 thyroid nodules in 491 patients undergoing consecutive ultrasonography and surgery at our hospital between 2011 and 2012.The ultrasonography examinations of thyroid nodules were routinely performed in the transverse planes.A taller-than-wide shape was defined as a ratio of anteroposterior diameter to transverse diameter in transverse plane ≥ 1.The sensitivity and specificity for thyroid carcinoma were analyzed.The data of thyroid carcinoma were formulated as follows:group 1,nodules ＞ 1 centimeter; group 2,≤ 1 centimeter.Their ratios of A/T were compared.The data were analyzed with SPSS 17.0 statistical software package.Results Among 683 nodules,499 were malignant and 184 benign.The sensitivity and specificity for malignancy were 61.5％ and 84.2％ respectively.There was significant difference (P =0.000).A taller-than-wide shape (A/T≥1) was more frequent in criterion 2 than criterion 1 (x2 =4.380,P =0.036).Conclusions A taller-than-wide shape (A/T≥ 1) is associated with thyroid malignancy especially thyroid microcarcinoma.And it is a useful ultrasonic feature for predicting thyroid microcarcinoma.