超声造影和超声弹性成像对甲状腺良恶性结节的鉴别诊断价值

目的 评价超声造影和超声弹性成像在甲状腺良恶性结节中的鉴别诊断价值.方法 对82个经手术病理证实的甲状腺良恶性结节的超声造影和弹性成像特征进行对比分析,评估各诊断方法的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率.结果 82个甲状腺结节中,良性病灶48个,恶性病灶34个.良性结节在注射造影剂后均早于周围腺体增强,晚于周围腺体廓清,多数结节表现为周边环状增强;恶性结节大多以低增强为主,增强回声不均匀,早于周边甲状腺组织消退.超声造影的灵敏度、特异度、阳性预测值及阴性预测值分别为91.18%、93.75%、91.18%及93.75%,弹性成像的灵敏度、特异度、阳性预测值及阴性预测值分别为88.24%、91.67%、88.24%及91.67%,超声造影联合超声弹性成像的灵敏度、特异度、阳性预测值及阴性预测值分别为97.06%、85.42%、82.50%及97.62%.结论 超声造影和弹性成像对甲状腺良恶性结节有较高的鉴别诊断价值,两者结合可提高该病的诊断率.

Value of contrast-enhanced ultrasound and ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules

Objective To assess the value of contrast - enhanced ultrasound （CEUS） and ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules. Methods Eighty - two benign and malignant thyroid nodules were confirmed by operations and pathology, their CEUS and ultrasonic elastography findings were compared and analyzed, and the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic rate were evaluated. Results In 82 nodules, there were 48 benign thyroid nodules, and 34 malignant thyroid nodules. After injection of contrast media the enhancement in benign nodules was earlier than peripheral gland and wash - out was later than peripheral gland, most nodules showed peripheral ring enhancement. Malignant nodules showed hypoenhancement, uneven enhanced echo, and wash - out of contrast agents was earlier than the peripheral thyroid tissue. The sensitivity, specificity, positive predictive value and negative predictive value of CEUS were 91. 18%, 93.75%, 91. 18% and 93.75%, respectively, while the sensitivity, specificity, positive predictive value and negative predictive value of ultrasonic elastography were 88. 24%, 91. 67%, 88. 24% and 91.67%, respectively, the sensitivity, specificity, positive predictive value and negative predictive value of CEUS combined with ultrasonic elastography were 97.06%, 85.42%, 82.50% and 97.62%, respectively. Conclusion Both CEUS and ultrasonic elastography have high value in differential diagnosis of benign and malignant thyroid nodules, the combination of two methods can improve the diagnostic rate.