超声弹性成像鉴别诊断实性甲状腺良、恶性小结节  

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

作　　者：陈越峰[1] 丛淑珍[1] 王煜[1] 甘科红[1] 王满立[1] 

机构地区：[1]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：《中国医学影像技术》2012年第2期252-255,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(粤科函社20101096号)

摘　　要：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≤10mm)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(χ2=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。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.

关 键 词：超声检查 甲状腺疾病 弹性成像技术 半定量评分 

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