超声弹性成像联合18F-FDG PET/CT对甲状腺结节良恶性诊断价值探讨

目的研究超声弹性成像(UE)与18F-FDGPET/CT单独或联合应用对良恶性甲状腺结节的诊断价值。方法回顾性研究2015年10月至2018年10月我院104例甲状腺结节患者临床资料,分析UE与18FFDG PET/CT检查结果并以病理诊断为金标准,探讨两种检查方法单独或联合诊断甲状腺结节灵敏度、特异度、准确性及一致性Kappa值。结果 104例患者共发现甲状腺结节134个,其中良性61个(45.52%),恶性73个(54.48%);UE检查显示61个良性结节中弹性成像评分≤2分者52个(85.25%),而73个恶性结节中评分>2分者58个(79.45%),良恶性结节弹性成像评分差异有统计学意义(P<0.05);良性结节边界不清、密度不均和钙化等CT征象比例,结节最大径及SUVmax均低于恶性结节,差异有统计学意义(P<0.05);UE、PET/CT及两者联合检测诊断甲状腺结节灵敏度分别为84.93%、90.41%和91.78%,特异度分别为90.16%、80.33%和93.44%,准确度分别为87.31%、85.82%和93.44%,一致性Kappa值分别为0.746、0.712和0.850。结论 UE与18F-FDGPET/CT均为甲状腺结节诊断的有效方法,且联合诊断可进一步提升诊断准确性。

Diagnostic Value of Ultrasound Elastography Combined with 18F-FDG PET/CT in the Diagnosis of Benign and Malignant Thyroid Nodules

Objective To study the diagnostic value of single use and combined use of ultrasound elastography(UE) and 18F-FDG PET/CT in the diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 104 patients with thyroid nodules from October 2015 to October 2018 were analyzed retrospectively. The examination results of UE and 18F-FDG PET/CT were analyzed, and the pathological diagnosis was used as the gold standard to explore the sensitivity, specificity, accuracy, and consistency Kappa value of single use and combined use of the two methods in the diagnosis of thyroid nodules. Results A total of 134 thyroid nodules were found in 104 patients, including 61 benign nodules(45.52%) and 73 malignant nodules(54.48%). The results of UE examination showed that there were 52 nodules(85.25%) of elastography score≤2 points among 61 benign nodules, and there were 58 nodules(79.45%) of score>2 points among 73 malignant nodules, and there was a significant difference in the elastography score between benign and malignant nodules(P<0.05). The proportions of CT signs of unclear boundary, uneven density and calcification, and the maximum diameter of nodules and SUVmax of benign nodules were lower than those of malignant nodules(P<0.05). The sensitivities of UE, PET/CT and the combined detection of thyroid nodules were 84.93%. 90.41% and 91.78%, and the specificities were 90.16%, 80.33% and 93.44% respectively, and the accuracies were 87.31%, 85.82% and 93.44%, and the consistency Kappa values were 0.746, 0.712 and 0.850 respectively. Conclusion Both of UE and 18F-FDG PET/CT are effective methods for the diagnosis of thyroid nodules, and combined diagnosis can further improve the diagnostic accuracy.