超声弹性应变率对甲状腺实性结节的诊断分析

目的探讨超声弹性应变率比值（SR）在甲状腺实性结节中的鉴别诊断价值，并寻找其鉴别良、恶性的最佳临界点。方法与病理结果对照，对沧州市人民医院于2012年2月至2012年9月收治的88例（118个病灶）甲状腺实性结节患者的临床资料进行回顾性分析，术前均进行常规超声及超声弹性成像检查，测量病灶与其周围同水平正常甲状腺组织的sR，绘制ROC曲线，确定诊断临界点。结果恶性组SR高于良性组，二者比较差异有统计学意义（t=6．743，P〈0．01）；良性组中，结节性甲状腺肿与腺瘤相对硬度比较差异无统计学意义（P〉0．05）。根据良恶性结节的sR绘制ROC曲线．曲线下面积为（0．865±0．036），确定1．86为最佳临界点，其灵敏度、特异度和准确度分别为85．7％、81．6％和83．9％。结论甲状腺实性结节中，SR对结节性甲状腺肿与腺瘤的鉴别能力不高，但有助于甲状腺良、恶性结节的鉴别诊断。

Analysis of Diagnostic Value of Ultrasonic Elastic Strain Thyroid Nodules

Objective To investigate value of the ultrasonic elastic strain ratio （SR） in the differential diagnosis of solid thyroid nodules, and find the best critical point in differentiating benign and malignant. Methods Eighty-eight patients with thyroid solid nodules （118 lesions）admitted to People＇s Hospital of Cangzhou City from 2012 February to 2012 September were retrospectively analyzed, the histopathological findings, routine preoperative ultrasound and ultrasound elastography examination were compared before sur- gery, SR of lesion and its same level surrounding normal thyroid tissue was meatured todraw ROC curve, and the diagnostic sector point was determined. Results SR in malignant group was higher than that in the benign group, the difference was statistically significant （t = 6. 743, P 〈 0.01 ） ;nodular goiter and adenoma relative hardness in tl~e benign group had no significant difference （ P 〉 0.05 ）. ROC curves were drawn according the SR in benign and malignant nodules,the area under the curve was（0. 865 ＋0. 036）. I. 86 was the optimal critical point, and its sensitivity, specificity, and accuracy were 85.7%, 81.6% and 83.9% respectively. Conclusion In solid nodules, the ability of SR to identify nodular goiter and adenoma is not high, but it can contribute to the differential diagnosis of benign and malignant thyroid nodules.