声脉冲辐射力弹性成像联合常规超声对甲状腺良恶性结节的诊断应用

目的探讨声脉冲辐射力弹性成像(ARFI)联合常规超声对甲状腺良恶性结节的诊断应用。方法选择我院收治的接受甲状腺手术的患者130例,于术前同一时间分别接受ARFI和常规超声检查。所有患者均经手术病理证实。以手术病理结果作为金标准,分别计算ARFI、常规超声检查以及两者联合诊断甲状腺良恶性结节的真实性、可靠性以及收益评价,并分别建立ROC曲线评价系统,计算ROC曲线下面积(AUC)。结果常规超声诊断:灵敏度为80%、特异度为71.43%,可靠性:粗一致性为82.86%。收益评价:约登指数=(灵敏度+特异度)-1=51.43%;ARFI诊断:灵敏度为85%、特异度为85.71%,可靠性:粗一致性为85.14%。收益评价:约登指数为70.71%;两者联合诊断真实性:灵敏度为92.5%、特异度为89.29%;可靠性:粗一致性为91.89%。收益评价:约登指数为81.79%。联合诊断较常规超声和ARFI比较,真实性和可靠性明显提高,差异具有统计学意义(P<0.05);以病理诊断为诊断"金标准",三组在甲状腺良恶性结节中的ROC曲线下面积分别为0.77、0.81、0.91。结论常规超声和ARFI均可用于鉴别诊断甲状腺良恶性结节,但两者联合诊断可明显提高真实性、可靠性以及收益评价,值得临床应用。

Diagnosis of Benign and Malignant Thyroid Nodules By Acoustic Pulsed Radiation Elastography Combined with Conventional Ultrasound

Objective To investigate the application of acoustic pulsed radiation elastography(ARFI)combined with conventional ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods We selected 130 patients who underwent thyroid surgery,and respectively received ARFI and routine ultrasound at the same time before surgery.All patients were confirmed by surgical pathology.The surgical pathology results were used as the gold standard to calculate the authenticity,reliability and benefit evaluation of ARFI,conventional ultrasonography and the combined diagnosis of benign and malignant thyroid nodules,and establish ROC curve evaluation system to calculate the area under the ROC curve(AUC).Results Conventional ultrasound diagnosis:sensitivity is 80%,specificity is71.43%,reliability:coarse consistency is 82.86%.Earnings evaluation:Yoden index=(sensitivity+specificity)-1=51.43%;ARFI diagnosis:sensitivity is 85%,specificity is 85.71%,reliability:coarse consistency is 85.14%.Earnings evaluation:The Yoden index is 70.71%;the combined diagnosis authenticity:sensitivity is 92.5%;specificity is 89.29%;reliability:coarse consistency is 91.89%.Earnings evaluation:The Yoden index is 81.79%.Compared with conventional ultrasound and ARFI,the combined diagnosis was significantly improved in terms of authenticity and reliability.The difference was statistically significant(P<0.05).The pathological diagnosis was used as the"gold standard"for diagnosis.The three groups were ROC in benign and malignant thyroid nodules.The area under the curve is 0.77,0.81,and 0.91,respectively.Conclusions Both conventional ultrasound and ARFI can be used to differentially diagnose benign and malignant thyroid nodules,but the combined diagnosis can significantly improve the authenticity,reliability and benefit evaluation,which is worthy of clinical application.