二维超声评分法联合超声造影在甲状腺结节良恶性鉴别诊断中的应用价值  

Application value of two-dimensional ultrasound scoring method combined with contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules

作　　者：詹燕[1] 徐立彦 ZHAN Yan;XU Li-yan(Department of Ultrasound,People's Hospital of Ganzi Tibetan Autonomous Prefecture ,Ganzi Tibetan Au-tonomous Prefecture,Ganzi 626000,China;Department of Respiratory Medicine,People's Hospital of Ganzi Tibetan Autonomous Prefecture ,Ganzi Tibetan Au-tonomous Prefecture,Ganzi 626000,China)

机构地区：[1]甘孜藏族自治州人民医院超声科,四川甘孜626000 [2]甘孜藏族自治州人民医院呼吸内科,四川甘孜626000

出　　处：《中国实验诊断学》2018年第12期2076-2080,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨二维超声(2DUS)评分法联合超声造影(CEUS)在甲状腺结节良恶性鉴别诊断中的应用价值。方法回顾性分析2015年10月-2017年10月我院195例行甲状腺结节切除术患者(223个结节)的临床资料,术前均行2DUS和CEUS检查,以术后病理结果为金标准,分析2DUS评分法联合CEUS诊断甲状腺结节良恶性的临床价值。结果病理结果显示,223个甲状腺结节中,良性结节149个,恶性结节74个;2DUS评分法诊断甲状腺结节良恶性的准确率为81.17%(181/223)、灵敏度为90.54%(67/74)、特异度为76.51%(114/149);甲状腺良性、恶性结节CEUS图像特征比较,差异存在统计学意义(P<0.05);CEUS评分诊断甲状腺结节良恶性的准确率为84.30%(188/223)、灵敏度为91.89%(68/74)、特异度为80.54%(120/149);联合诊断评分以5分为临界值,<5分为良性(145例),≥5分为恶性(78例),与病理检查结果比较,联合诊断准确率为92.83%(207/223)、灵敏度为91.89%(68/74)、特异度为93.29%(139/149)。结论 2DUS评分法联合CEUS可明显提高甲状腺结节良恶性的诊断效能,联合评分5分可作为诊断甲状腺结节良恶性的临界值。Objective To explore the application value of two-dimensional ultrasound (2DUS)scoring method com- bined with contrast-enhanced ultrasound (CEUS)in the differential diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 195 patients (223 nodules)scheduled to thyroid nodule resection in our hospital from October 2015to October 2017were analyzed retrospectively,and they were given 2DUS and CEUS before operation.The clinical value of 2DUS scoring and CEUS in the diagnosis of benign and malignant thyroid nodules was analyzed with the postoperative pathological results as gold standard.Results Pathological results showed that there were 14:9 benign nodules and 74 malignant nodules among 223 thyroid nodules.The accuracy,sensitivity and specificity of 2DUS scoring method were 81.17%(181/223),90.54%(67/74) and 76.51%(114/149)in the diagnosis of benign and malignant thyroid nodules.There were statistically significant differences in CEUS image features between benign and malignant thyroid nodules (P<0.05).The accuracy,sensitivity and specificity of CEUS score were 84.30%(188/223),91.89% (68/74) and 80.54%(120/149) in the diagnosis of benign and malignant thyroid nodules.5points was the critical val- ues of combined diagnosis score,and <5 points was classified as benign (145cases),and ≥5 was classified as malig- nant (78 cases).Compared with pathological examination results,the accuracy,sensitivity and specificity of combined diagnosis were 92.83%(207/223),91.89%(68/74) and 93.29%(139/149).Conclusion 2DUS scoring method com- bined with CEUS can significantly improve the diagnostic efficiency of benign and malignant thyroid nodules.A com- bined score of 5 points can be used as a critical value in the diagnosis of benign and malignant thyroid nodules.

关 键 词：二维超声评分法 超声造影 甲状腺结节 良恶性 

分 类 号：R736.1[医药卫生—肿瘤]