Diagnostic value of thyroid ultrasound and thyroid function in elderly patients with thyroid nodules / 中华老年医学杂志

ABSTRACT

Objective To investigate the diagnostic value of thyroid ultrasonography and thyroid function in elderly patients with thyroid nodules.Methods Clinical data of 190 elderly patients with thyroid nodules admitted into our hospital from July 2017 to June 2018 were retrospectively analyzed.All patients underwent examinations of thyroid function,thyroid ultrasound and postoperative histology.The diagnostic value of thyroid function and thyroid ultrasound was analyzed.Results Of the 190 cases,161 cases were diagnosed with benign thyroid nodules and 29 cases with malignant nodules by histological examination after thyroidectomy.Patients with benign thyroid nodules had slightly higher levels of thyroxine(TT4),triiodothyronine(TT3)and thyroid stimulating hormone (TSH)than patients with malignant nodules,but the differences were not statistically significant(84.32±56.31 mmol/L vs.82.66±53.05 mmol/L,2.05±0.75 mmol/L vs.1.98±0.57 mmol/L,2.32±3.20 mmol/L vs.1.97±0.90 mmol/L,t =0.171,0.554 and 0.677,P=0.432,0.290 and 0.249,respectively).There were 45 cases(27.9％),68 cases (42.2％) and 48 cases(29.8％) of benign thyroid nodules and 3 cases (10.3％),20 cases (68.9％) and 6 cases (20.7％) of thyroid malignancies in patients with TSH levels lower than 1.00 mmol/L,between 1.00 and 4.00 mmol/L and higher than 4.00 mmol/L,respectively,indicating the proportion of patients with TSH levels between 1.00 and 4.00 mmol/L was higher in malignant patients than in benign patients(x2 =7.899,P=0.005),but the incidence of malignant thyroid nodules was not higher with increased TSH levels.Patients with malignant nodules were more likely to show unclear boundaries,irregular morphology,microcalcifications,hypoechoicity or type Ⅲ vascular pattern on ultrasound than patients with benign nodules(x2 =6.385,15.525,4.062,4.062 and 4.487,P=0.012,0.000,0.044,0.044 and 0.034,respectively).Conclusions Thyroid nodules are mostly benign in the elderly.The malignant rate of thyroid nodules does not increase along with the TSH level.Thyroid nodules with unclear boundaries,irregular shapes,microcalcifications,hypoechoicity or type Ⅲ vascular pattern on ultrasound have a higher possibility of malignant transformation.