三维容积成像在甲状腺实性结节诊断中的应用  

Application of three-dimensional volume ultrasound in diagnosis of solid thyroid nodules

作　　者：韩若凌[1] 王艺[1] 张凤娟[1] 孟洁[1] 高洁宁[1] 

机构地区：[1]河北医科大学第四医院超声科,河北石家庄050011

出　　处：《中国医学影像技术》2015年第10期1510-1514,共5页Chinese Journal of Medical Imaging Technology

基　　金：河北省自然科学基金(H2015206405);河北省高校强势特色学科--第四医院肿瘤学支持项目(冀教高[2005]52号)

摘　　要：目的探讨三维容积成像在甲状腺实性结节良恶性鉴别中的应用价值。方法对119例甲状腺实性结节手术患者共144个结节行二维及三维超声检查,利用三维容积及断层技术行三维重建,分析良恶性结节的冠状面成像特征,评价其诊断价值。结果 144个结节中,良性结节75例,恶性结节69例。冠状面成像特征中,良恶性结节的形态、边界、边缘有无成角或毛刺、内部回声及有无微钙化差异均有统计学意义(P均<0.05)。建立Logistic回归模型,最终进入模型的甲状腺恶性结节冠状面成像特征包括形态不规则、边缘成角或毛刺、低回声。三维超声诊断甲状腺恶性实性结节的敏感度为92.75%(64/69),特异度为85.33%(64/75),准确率为88.89%(128/144),均高于二维超声[89.86%(62/69),80.00%(60/75),84.72%(122/144)],但两者的诊断效能差异均无统计学意义(P均>0.05)。结论在三维冠状面成像中,甲状腺良恶性结节的特征差异显著。三维容积成像在甲状腺实性结节的良恶性鉴别诊断中具有重要的价值。Objective To evaluate the clinical value of three-dimensional（3D）volume ultrasound in differential diagnosis of benign and malignant solid thyroid nodules.Methods Totally 119 patients scheduled for surgery with 144 solid thyroid nodules were examined with two-dimensional（2D）and 3Dultrasound respectively.The coronal plane sonographic features and diagnostic performances were analyzed.Results The solid thyroid nodules consisted of 75 benign lesions and 69 cancers confirmed by pathology.The coronal plane sonographic features showed significant difference between benign and malignant solid thyroid nodules in shape,margin,angulation or speculation,echogenicity and microcalcification（all P〈0.05）.Multiple Logistic regression analysis demonstrated that coronal plane sonographic features of thyroid cancer included irregular shape,angulation or spiculatin,hypo-echogenicity.The sensitivity,specificity and accuracy rate of 3Dvolume ultrasound were 92.75%（64/69）,85.33%（64/75）,88.89%（128/144）,which were superior to 2Dultrasound with89.86%（62/69）,80.00%（60/75）,84.72%（122/144）.However,the diagnostic performance of the two sonographic techniques had no statistical difference（all P〈0.05）.Conclusion There is a significant difference between benign and malignant solid thyroid nodules in coronal plane sonographic features.3Dvolume ultrasound is great valuable in differential diagnosis of benign and malignant solid thyroid nodules.

关 键 词：甲状腺结节 三维容积成像 超声检查 诊断 

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