超声弹性成像技术对慢性淋巴细胞性甲状腺炎结节的鉴别诊断价值

目的 探讨分析超声弹性成像技术对慢性淋巴细胞性甲状腺炎（CLT）结节的鉴别诊断价值。方法 回顾性分析北京积水潭医院住院手术治疗的84 例CLT 合并甲状腺实性结节患者的临床资料。结节112个，经病理证实合并良性结节41 个，合并恶性结节患者71 个。患者术前行常规超声和超声弹性成像检查，分析2 种检查方式对CLT 合并微小结节的诊断价值。结果 常规超声诊断敏感性为74.65%，特异性为63.41%，准确率为70.54% ；采用超声弹性评分法诊断敏感性为87.32%，特异性为85.37%，准确率为86.61% ；常规超声联合超声弹性评分诊断敏感性为94.37%，特异性为97.56%，准确率为95.54% ；超声弹性应变率比值诊断敏感性为83.10%、特异性为90.24%、准确率为85.71%。采用ROC 曲线分析超声弹性评分和弹性应变率比值对良恶性结节的诊断价值，结果显示，超声弹性评分诊断曲线下面积为0.872，弹性应变率比值诊断曲线下面积为0.922。结论 超声弹性成像可反映甲状腺结节硬度，其中弹性评分和弹性应变率比值有较高的诊断价值，在实际工作中可联合运用超声弹性成像技术和常规超声检查，以提高CLT患者合并甲状腺结节的鉴别诊断准确率。

Ultrasound elastography for differential diagnosis of small thyroidnodules in chronic lymphocytic thyroiditis

Objective To explore the value of ultrasound elastography in differential diagnosis of smallnodules in patients with chronic lymphocytic thyroiditis (CLT). Methods A retrospective analysis was made for84 cases of CLT in Beijing Jishuitan Hospital. There were totally 112 thyroid nodules, pathology confirmed 41cases of benign nodules and 71 cases of malignant nodules. All patients were examined by routine ultrasonographyand ultrasound elastography before operation. The value of the two kinds of examination methods for diagnosis ofCLT combined with small nodules was analyzed. Results The sensitivity of conventional ultrasonic diagnosis was74.65%, the specificity was 63.41%, and the accuracy rate was 70.54%. The diagnostic sensitivity of ultrasoundelastography was 87.32%, the specificity was 85.37% and the accuracy rate was 86.61%. The sensitivity ofconventional ultrasonography combined with ultrasound elastography was 94.37%, the specificity was 97.56% andthe accuracy rate was 95.54%. The sensitivity of ultrasonic elastic strain rate ratio was 83.10%, the specificity was90.24% and the accuracy rate was 85.71%. The ROC curve was used to analyze the diagnostic value of the ultrasonicelastic score and the ultrasonic elastic strain rate ratio for benign and malignant nodules. The results showed that the area under the curve of the ultrasonic elastic score was 0.872, and the area under the elastic strain rate ratio was 0.922. Conclusions Ultrasound elastography can reflect the hardness of thyroid nodules. Both ultrasonic elastic score and ultrasonic elastic strain rate ratio are of high diagnostic value. In practical work, ultrasound elastography and conventional ultrasonography can be combined to improve the diagnostic accuracy of thyroid nodules in the patients with chronic lymphocytic thyroiditis.