实时超声弹性成像诊断甲状腺实性结节的价值

目的：探讨实时超声弹性成像在甲状腺实性结节中的诊断和鉴别诊断价值。方法方便收集2013年5月—2015年8月在该院接受手术治疗的甲状腺实性结节患者70例98个结节，均经病理诊断确诊，采用灰阶超声和彩超及实时超声弹性成像检查，比较各种检查方法对甲状腺结节诊断的准确性、敏感度和特异度。结果98个结节灶中，实时超声弹性成像检出良性83个(其中0级52个、1级31个)、恶性15个(其中2级7个、3级4个、4级4个)。弹性成像分级为2级的结节灶是绿色和蓝色共存的过渡阶段，由于硬度不均，容易产生假阳性和假阴性。弹性成像对甲状腺结节良恶性准确性、灵敏度、特异度明显高于灰阶联合彩超(P<0.05)，超声弹性成像联合灰阶超声的准确性、灵敏度、特异度较单纯超声弹性成像有所提高，差异无统计学意义(P>0.05)。结论实时超声弹性成像属于无创、检查方便快捷的检查方法，对甲状腺结节的良恶性诊断准确性、敏感度和特异度均高于灰阶超声和彩超，尤其是联合灰阶超声可一定程度提高敏感度和特异度，具有较高的诊断价值。

Value of Real-time Ultrasound Elastography in Diagnosis of Thyroid Solid Nodules

Objective To study the value of real-time ultrasound elastography in diagnosis and differential diagnosis of thy-roid solid nodules. Methods 98 nodules from 70 cases with thyroid solid nodules receiving operative treatment and diag-nosed by pathology in our hospital from May 2013 to August 2015 were collected, and all patients were examined by gray scale ultrasound, color Doppler ultrasound and real-time ultrasound elastography, and the accuracy, sensitivity degree and specificity degree of various examination methods in diagnosis of thyroid nodules were compared. Results Of 98 nodules, 83 benign nodules (level 0 was in 52, level 1 was in 31) and malignant nodules ( level 2 was in 7, level 3 was in 4, level 4 was in 4) were detected by real-time ultrasound elastography, nodules in level 2 of elasticity imaging grading were the transition phase of coexistence of green and blue, and false positive and false negative were prone to occur due to the non-uniform hardness, the accuracy, sensitivity degree and specificity degree of elasticity imaging in diagnosis of benign and malignant thyroid nodules were obviously higher than those of gray scale combined with color Doppler ultrasound(P<0.05), but the ac-curacy, sensitivity degree and specificity degree of elasticity imaging combined with gray scale ultrasound were obviously improved compared with those of simple ultrasound elasticity imaging, but the difference was not obvious (P>0.05). Con-clusion Real-time ultrasound elastography belongs to the noninvasive, easy and convenient examination method, and the accuracy, sensitivity degree and specificity degree of it in diagnosis of benign and malignant thyroid nodules were higher than those of gray scale ultrasound and color Doppler ultrasound, and it can improve the sensitivity and specificity to a cer-tain degree especially combined with gray scale ultrasound, and it is of higher diagnostic value.