超声造影联合弹性成像在甲状腺微小乳头状癌诊断中的应用研究

目的 探讨超声造影联合弹性成像在甲状腺微小乳头状癌诊断中的应用价值.方法 选取甲状腺微小乳头状癌患者59例,共85个结节.分别对患者行超声造影、弹性成像及超声造影联合弹性成像检查.以病理诊断为"金标准",比较超声造影、弹性成像及二者联合诊断甲状腺微小乳头状癌的准确度、敏感度、特异度、阳性预测值及阴性预测值.结果 恶性结节超声造影增强模式的各项指标与良性结节比较,差异均无统计学意义(P﹥0.05);超声造影联合弹性成像诊断甲状腺微小乳头状癌的敏感度、特异度、阳性预测值及阴性预测值均高于超声造影、弹性成像单独检测,但差异无统计学意义(P﹥0.05);超声造影联合弹性成像诊断甲状腺微小乳头状癌的准确度为95.29%,高于超声造影的81.18%及弹性成像的83.53%,差异有统计学意义(P﹤0.05).结论 采用超声造影联合弹性成像对甲状腺微小乳头状癌进行诊断,可显著提高诊断的准确度,减少误诊、漏诊的发生,具有临床推广意义.

Application of contrast-enhanced ultrasound combined with elastography in the diagnosis of papillary thyroid microcarcinoma

Objective To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with elastography in the diagnosis of papillary thyroid microcarcinoma (PTMC). Method 59 cases of PTMC, with a total of 85 nodules, were enrolled in the study. CEUS, elastography and the combined detection were administered in these pa-tients, respectively. With pathological diagnosis as the gold standard, the accuracy, sensitivity, specificity, positive predic-tive value, and negative predictive value of the three examination regimens in the diagnosis of PTMC were compared. Re-sult The characteristics of malignant and benign nodules detected using CEUS were similar (P>0.05); the sensitivity, specificity, positive predictive value and negative predictive value of CEUS combined with elastography in detecting PT-MC was higher than those using CEUS or elastography alone, though there were no significant differences observed (P>0.05);the accuracy of combined detection in the diagnosis of PTMC was 95.29%, which was significantly higher than the CEUS alone at 81.18%and elastography alone at 83.53%, and the differences were of statistically significance (P<0.05). Conclusion CEUS combined with elastography may significantly improve the accuracy in the diagnosis of PTMC, and reduce the rate of misdiagnosis and missed diagnosis, which is clinically applicable.