常规超声评分结合弹性成像诊断甲状腺实性结节

目的探讨超声弹性成像诊断甲状腺实性结节良恶性的价值。方法对106例患者共128枚甲状腺实性结节进行回顾性分析,与病理结果对照,分别计算常规超声评分(Ⅰ组)、弹性成像(Ⅱ组)及两者联合(Ⅲ组)诊断甲状腺实性结节良恶性的敏感度、特异度及准确率,评价其诊断价值。结果常规超声评分组诊断甲状腺实性结节良恶性的敏感度、特异度、准确率为76.9%、81.6%、79.7%;弹性成像组为75.0%、84.2%、80.5%;两者联合组92.3%、90.8%、91.4%。Ⅰ组与Ⅱ组间差异无统计学意义(P>0.05);Ⅰ组与Ⅲ组间差异有统计学意义(P<0.05);Ⅱ组与Ⅲ组间差异有统计学意义(P<0.05)。对于≤1 cm的甲状腺实性结节,常规超声评分敏感度、特异度、准确率为62.5%、70.0%、67.9%;弹性成像为87.5%、90.0%、89.8%;两者联合为100%、95.0%、96.4%。Ⅰ组与Ⅱ组间差异有统计学意义(P<0.05);Ⅰ组与Ⅲ组间差异有统计学意义(P<0.05)。结论常规超声评分与弹性成像诊断甲状腺实性结节良恶性效能相当,两者联合能提高诊断水平。对于≤1 cm的甲状腺实性结节,弹性成像更具优势,具有重要临床价值。

Conventional ultrasound scoring method combined with elastography in diagnosis of thyroid solid nodules

Objective To explore the value of ultrasonic elastography （UE） in diagnosis of benign and malignant thyroid solid nodules. Methods 128 thyroid solid nodules （106 patients ） compared with pathological results were retrospectively analyzed with conventional ultrasound scoring methods （Group Ⅰ） , ultrasonic elastography （Group Ⅱ） , and the combination of them（ Group Ⅲ ） . The sensitivity , specificity and accuracy were calculated to evaluate the value of each method. Results The sensitivity , specificity and accuracy of Group Ⅰ were 76.9% ,81.6% ,79.7% , while for Group Ⅱ were 75.0% ,84.2% ,80.5%. There were no significant differences between two groups. The sensitivity, specificity and accuracy of the combination of them were 92.3% ,90.8% ,91.4% , better than each method separately. For the nodules length ≤ 1cm, the sensitivity, specificity and accuracy of Group Ⅰ were 62.5% ,70.0% ,67.9% , while for Group Ⅱ were 87.5% ,90.0% , 89.8% ,for Group Ⅲ were 100% ,95.0% ,96.4%. There were significant differences in conventional ultrasound scoring method group and UE group. Conclusions The conventional ultrasound scoring method combined with the UE can improve the accuracy in diagnosis of benign and malignant thyroid nodules. The UE plays an important role in differentiating benign and malignant nodules of thyroid length ≤ 1 cm.