超声造影对甲状腺可疑结节的定性诊断价值  

Value of contrast-enhanced ultrasonography in qualitative diagnosis of suspicious thyroid nodules

作　　者：范雪[1] 候雪琴[1] 杨凌菲 董建[1] 宋涛[1] FAN Xue HOU Xueqin YANG Lingfei DONG Jian SONG Tao(Department of Abdominal Ultrasound Diagnose, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院腹部超声诊断科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2017年第1期26-29,34,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81260220)

摘　　要：目的探讨超声造影对不同病理类型甲状腺可疑结节的诊断价值。方法对358例患者424个甲状腺结节行超声造影检查,给予超声造影后定性诊断结果,以术后病理结果为金标准,对超声造影诊断结果与病理结果进行对比,应用χ2检验,对比良、恶性结节不同病理类型的诊断有无差异。结果 (1)超声造影对甲状腺结节良恶性诊断的灵敏度85.3%,特异度为65.4%,阳性预测值为91.6%,阴性预测值为50.0%,诊断符合率为81.6%。(2)恶性结节中甲状腺乳头状癌超声造影诊断符合率为92.2%,误诊率为7.8%;甲状腺微小乳头状癌诊断符合率为91.4%,误诊率为8.6%;结甲并乳头状癌诊断符合率为53.8%,误诊率为46.2%;桥本氏甲状腺炎并乳头状癌诊断符合率为72.7%,误诊率为27.3%,χ2=45.700,不同病理类型甲状腺恶性结节的超声造影诊断有显著差异,并且其差异具有统计学意义(P<0.01)。(3)良性结节中结节性甲状腺肿诊断符合率为66.7%,误诊率为33.3%;结节性甲状腺肿合并胶原变、纤维化或乳头状增生诊断符合率为71.7%,误诊率28.3%;桥本氏甲状腺炎诊断符合率为42.9%,误诊率为57.1%,χ2值为3.973,不同病理类型甲状腺良性结节的超声造影诊断的差异不具有统计学意义(P>0.05)。结论超声造影对于甲状腺乳头状癌、微小乳头状癌及桥本背景下的乳头状癌诊断符合率较高,误诊率较低,对于结甲合并乳头状癌的诊断符合率较低,误诊率较高,不同病理类型甲状腺良性结节的超声造影诊断无明显差异。Objective To explore the value of qualitative diagnosis of suspicious thyroid nodules in different pathological type using contrast-enhanced ultrasonography （CEUS）.Methods A total of 424 suspicious thyroid nodules in 358 cases were given qualitative diagnosis after CEUS examination,with the postopera-tive pathologic results as the gold standard,and compared the difference of diagnosis between the CEUS diagnosis and pathologic results on the different pathological types of malignant and benign nodules by the Fisher′s Exact Test.Result （1 ）The sensitivity of CEUS diagnosis in the thyroid malignant and benign nodules was 85.3%,specificity was 65.4%,positive predictive value and negative predictive value were 91.6% and 50%,respectively,and the diagnostic coincidence rate was 81.6%.（2）In the malignant nod-ules,the diagnostic coincidence rate and the false dismissal rate of the CEUS diagnosis in the papillary thy-roid carcinoma was 92.2% and 7.8% respectively,the diagnostic coincidence rate and the false dismissal rate of the CEUS diagnosis in the papillary thyroid microcarcinoma were 91.4% and 8.6% respectively,the diagnostic coincidence rate and the false dismissal rate of the CEUS diagnosis in the papillary thyroid carci-noma with nodular goiter were 53.8% and 46.2% respectively,the diagnostic coincidence rate and the false dismissal rate of the CEUS diagnosis in the papillary thyroid carcinoma with Hashimoto′s thyroiditis were 72.7% and 27.3% respectively,the 2 value was 45.700,which there was significant difference of the differ-ent pathological types of thyroid malignant nodules in CEUS diagnosis （P 〈0.01）.（3）In the benign nod-ules,the diagnostic coincidence rate and the misdiagnosis rate of the CEUS diagnosis in nodular goiter were 66.7% and 33.3% respectively,the diagnostic coincidence rate and misdiagnosis rate of the CEUS di-agnosis in nodular goiter with collagen or fibrosis and papillary hyperplasia were 71.7% and 28.3% respec-tively,the diagnostic coincidence rate and misdiagnosis

关 键 词：超声造影 甲状腺结节 病理类型 CONTRAST-ENHANCED ultrasonograph (CEUS) 

分 类 号：R445.1[医药卫生—影像医学与核医学]