超声弹性成像鉴别诊断实性甲状腺良、恶性小结节

目的 探讨超声弹性成像鉴别诊断良、恶性甲状腺实性小结节(最大径≤10 mm)的价值.方法 分析109个甲状腺实性小结节的常规超声及超声弹性成像图像.常规超声采用半定量评分方法判断结节的性质.超声弹性成像采用5级评分法判断结节性质.以术后病理结果为诊断金标准,构建ROC曲线,比较两种方法对良、恶性甲状腺实性小结节的诊断率.结果 超声弹性成像诊断良、恶性甲状腺实性小结节的敏感度、特异度、准确率分别为88.89％(16/18)、84.62％(77/91)、85.32％(93/109).半定量评分法诊断良、恶性甲状腺实性小结节的敏感度、特异度、准确率分别为77.78％(14/18)、81.32％(74/91)、80.73％(88/109).超声弹性诊断准确率高于半定量评分方法(x2=31.25,P＜0.05).超声弹性成像及半定量评分方法诊断甲状腺良、恶性结节的ROC曲线下面积分别为0.88和0.80,差异有统计学意义(Z=4.032,P＜0.01).结论 超声弹性成像有助于鉴别诊断甲状腺良、恶性实性小结节.

Ultrasonic elastography in differential diagnosis of benign and malignant small thyroid solid nodules

Objective To investigate the value of ultrasonic elastography(UE) in differential diagnosis of benign and malignant thyroid small solid nodules with diameter ≤10 mm.Methods Ultrasound(US) and UE images of 109 thyroid small solid nodules were analyzed.Semi-quantitative score was evalated with US and 5-score evaluation was performed with UE.Taking pathological results as gold standard,receiver operating characteristic curve(ROC) was draw,and the diagnostic accuracy was compared between the two methods.Results The sensitivity,specificity and accuracy of UE was 88.89%(16/18),84.62%(77/91) and 85.32%(93/109),respectively,while of semi-quantitative scores was 77.78%(14/18),81.32%(74/91) and 80.73%(88/109),respectively.The accuracy of UE was higher than semi-quantitative scores in diagnosing benign and malignant thyroid small nodules(χ2=31.25,P<0.05).The areas under ROC curve of UE and semi-quantitative scores were 0.88 and 0.80,respectively(Z=4.032,P<0.01).Conclusion UE is helpful in differentiating malignant and benign thyroid small solid nodules.