常规超声与超声造影联合评分对甲状腺良恶性结节的鉴别诊断价值  

Value of differential diagnosis between benign and malignant thyroid nodules using scores taken from conventional ultrasonography combined with contrast-enhanced ultrasonogram

作　　者：陶玲玲[1] 王天翔[2] 李小恩[2] 李伟伟[3] 黄芸谦 樊金芳 陈曼[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声科,上海市200025 [2]上海交通大学医学院附属瑞金医院卢湾分院普外科 [3]上海交通大学医学院附属瑞金医院卢湾分院超声科

出　　处：《临床超声医学杂志》2015年第4期227-230,共4页Journal of Clinical Ultrasound in Medicine

基　　金：上海市黄浦区卫生局重点专科课题(超声专科建设课题2)

摘　　要：目的探讨常规超声与超声造影联合评分对甲状腺良恶性结节的鉴别诊断价值。方法经手术病理证实的160个甲状腺结节,术前行常规超声和超声造影检查,评估各项观察指标,对每个甲状腺结节进行赋值评分。绘制常规超声及常规超声联合超声造影评分的ROC曲线。结果常规超声显示良恶性结节的纵横比、边界、形态、内部回声、钙化及后方衰减等指标比较差异均有统计学意义(均P﹤0.05);超声造影显示良恶性结节的灌注强度、灌注均匀性、有无环形增强、增强快慢及消退快慢等指标比较差异均有统计学意义(均P﹤0.05)。根据ROC曲线推断常规超声诊断界值为1.5分,常规超声联合超声造影诊断界值为4.5分,两种方法的敏感性、特异性、准确性分别为91.0%、71.0%、79.4%和82.1%、83.9%、92.5%;两种方法的曲线下面积分别为0.810和0.822。结论常规超声联合超声造影有助于甲状腺良恶性结节的鉴别诊断。Objective To explore the application of conventional ultrasound combined with contrast-enhanced ultrasonography in diagnosis of thyroid nodules.Methods Data of 160 thyroid nodules were enrolled in this study. All patients underwent both conventional ultrasound and contrast-enhanced ultrasound.All data of imaging characteristics were recorded for assessment. The receiver operating characteristic（ROC） curve analyses were conducted to determine the diagnostic values of the conventional ultrasound and contrast-enhanced ultrasound in differentiating benign and malignant thyroid nodules.Results There were significant difference of the characteristics of conventional ultrasound and conventional ultrasound combined with contrast-enhanced ultrasound（all P 〈 0.05）.According to ROC curve,the cut off value for conventional ultrasound was 1.5points,and 4.5 points for conventional ultrasound combined with contrast-enhanced ultrasound.The sensitivity,specificity and accuracy for conventional ultrasound were 91.0%,71.0%,79.4%,respectively,and 82.1%,83.9%,92.5% for conventional ultrasound combined with contrast-enhanced ultrasound, respectively. The area under the curve were 0.810 for conventional ultrasound and 0.822 for conventional ultrasound combined with contrast-enhanced ultrasound.Conclusion Combined conventional ultrasonography and contrast-enhanced ultrasonography is capble of increasing differential diagnostic valuefor thyroid nodules.

关 键 词：超声检查 造影剂 甲状腺结节 良恶性 

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