超微血流显像在甲状腺微小结节诊断中的应用价值分析

目的 研究超微血流显像(SMI)在甲状腺微小结节(TSN)诊断中的应用价值.方法 选择136例TSN患者,结节数目169个,先行二维超声及彩色多普勒超声检查,发现可疑结节后启动SMI、彩色多普勒血流显像(CDFI)模式进行诊断,比较SMI、CDFI诊断TSN良恶性的敏感度、特异度、阳性预测值、阴性预测值,以及SMI、CDFI模式下良恶性TSN的血流分级和血供分型.结果 经病理检查,169个结节中,恶性结节97个(57.40%),良性结节72个(42.60%).以病理检查结果为金标准,SMI诊断TSN良恶性的敏感度(92.78%)、特异度(95.83%)、阳性预测值(96.77%)、阴性预测值(90.79%)均高于CDFI诊断的敏感度(82.47%)、特异度(80.56%)、阳性预测值(85.11%)、阴性预测值(77.33%).SMI模式下良性TSN血流检出率(88.89%)高于CDFI模式(68.05%),恶性TSN血流检出率(52.58%)低于CDFI模式(71.13%),差异均有统计学意义(P﹤0.05).SMI、CDFI模式下良恶性TSN的血流分级和血供分型比较,差异均有统计学意义(P﹤0.05).结论 SMI可有效判断微小血管及低速血流,准确观察微细血管,敏感度、特异度及血流检出率均较高,在TSN良恶性的辅助诊断上具有较高的应用价值.

Application of superb microvascular imaging in the diagnosis of thyroid nodules

Objective To study the diagnostic value of superb microvascular imaging (SMI) in thyroid small nodules (TSN). Method 136 cases of TSN patients, with a total of 169 nodules, were initially examined by 2D ultrasound and color Doppler ultrasound, while the SMI and color doppler flow imaging (CDFI) were performed for diagnosis of suspect-ed nodules, and then the SMI and CDFI were compared for sensitivity, specificity, as well as positive predictive value and negative predictive value in detecting benign/malignant TSN, of which the blood flow and blood supply detected using SMI and CDFI were analyzed. Result Of the 169 nodules, 97 (57.40%) malignant nodules, and 72 (42.60%) benign nod-ules were confirmed pathologically. Taking pathological findings as the gold standard, the SMI determined benign or ma-lignant TSN with higher sensitivity (92.78%), specificity (95.83%), positive predictive value (96.77%), and negative pre-dictive value (90.79%) than the CDFI mode sensitivity (82.47%), specificity (80.56%), positive predictive value (85.11%), negative predictive value (77.33%), respectively]. The detection rate of blood flow (88.89%) in benign TSN was higher using SMI vs using CDFI (68.05%), while that in malignant TSN was lower in SMI (52.58%) compared with CDFI (71.13%) (P<0.05). Overall, SMI and CDFI were significantly different in respect of detecting the blood flow and blood supply for benign and malignant TSN (P<0.05). Conclusion SMI can effectively distinguish microvessels and low-velocity blood flow, facilitating accurate observation of microvessels, with acceptable sensitivity, specificity and de-tection rate of blood flow, and is highly applicable for adjuvant diagnosis of benign or malignant TSN.