实时超声弹性成像在甲状腺结节诊断中的临床价值  

Clinical Value of Real-Time Elastosonography in Diagnosis of Thyroid Nodules

作　　者：王毅钧[1] 丛淑珍[2] 赵刚[1] 吴泽宇[1] 彭林[1] 

机构地区：[1]广东省医学科学院.广东省人民医院血管甲状腺腹壁疝外科,广东广州510080 [2]广东省医学科学院.广东省人民医院超声科,广东广州510080

出　　处：《中国普外基础与临床杂志》2011年第8期819-822,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨实时超声弹性成像在甲状腺结节诊断中的临床应用价值。方法对2009年6-12月期间收入我院血管甲状腺腹壁疝外科并行实时超声弹性成像检查的168例甲状腺结节性疾病患者的临床资料进行回顾性分析,将实时超声弹性成像图按弹性硬度分为0-Ⅳ级（0-Ⅱ级为良性,Ⅲ-Ⅳ级为恶性）,并与病理学结果进行比较。结果 168例患者共208个结节：结节性甲状腺肿125个;甲状腺腺瘤36个;甲状腺恶性肿瘤41个,其中39个为甲状腺乳头状癌,1个为甲状腺髓样癌,1个为甲状腺非霍奇金淋巴瘤;其他结节6个,包括弥漫性毒性甲状腺肿1个、灶性淋巴细胞性甲状腺炎3个、亚急性肉芽肿性甲状腺炎2个。弹性分级为0-Ⅱ级的结节148个,Ⅲ-Ⅳ级者60个。根据病理学结果,良性结节占0-Ⅱ级的97.3%（144/148）,占Ⅲ-Ⅳ级的38.3%（23/60）;恶性结节占0-Ⅱ级的2.7%（4/148）,占Ⅲ-Ⅳ级的61.7%（37/60）。实时超声弹性成像的诊断敏感度为90.2%（37/41）,特异度为86.2%（144/167）,准确度为87.0%（181/208）。结论实时超声弹性成像能反映甲状腺结节的相对硬度,为诊断提供有用信息,有助于鉴别诊断甲状腺结节的良、恶性。Objective To investigate the clinical value of real-time elastosonography in diagnosis of thyroid nodules.Methods The clinical date of 168 patients with thyroid nodules,admitted to our hospital from June 2009 to December,were retrospectively analyzed with pathological findings as the reference standard.The findings on elastography were classified into five grades： grade 0 to Ⅳ.The nodules with grade less than Ⅱ were diagnosed as benign,otherwise more than Ⅲ were diagnosed as malignancy.Results There were 208 nodules in 168 patients： nodular goiter was in 125 cases,thyroid adenoma in 36 cases,thyroid malignant tumor in 41 cases including 39 cases for thyroid papillary carcinoma,1 case for thyroid medullary carcinoma,1 case for thyroid non-Hodgkin lymphoma.Other nodules were in 6 cases,including diffuse toxic goiter in 1 case,local lymphocytic thyroiditis in 3 cases,and subacute granulomatous thyroiditis in 2 cases.There were 148 thyroid nodules in grade 0-Ⅱ and 60 nodules in grade Ⅲ-Ⅳ.According to the pathological findings,97.3%（144/148） thyroid nodules of grade 0-Ⅱ were benign,however,38.3%（23/60） of grade Ⅲ-Ⅳ were benign.Furthermore,2.7%（4/148） thyroid nodules of grade 0-Ⅱ were malignancy,while 61.7%（37/60） of grade Ⅲ-Ⅳ were malignancy.The sensitivity,specificity,and accuracy of the real-time elastosonography in diagnosis of thyroid nodules was 90.2%（37/41）,86.2%（144/167）,and 87.0%（181/208）,respectively.Conclusion Real-time elastosonography can reflect the relative hardness of thyroid nodules and provide useful information for diagnosis,which is helpful in differentiating benign and malignant thyroid nodules.

关 键 词：超声检查 弹性成像 甲状腺结节 诊断 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]