甲状腺剪切波弹性成像假性结果二维超声特点的分析  

Analysis of sonographic characteristics of thyroid nodules diagnosed as false positive or negative results in shear wave elastography

作　　者：那子悦 乔强[1] 王秋程[1] 周明岩[1] 袁沙沙[1] 温欣[1] 程文[1] NA Ziyue QIAOQiang WANG Qiucheng ZHOUMingyan YUAN Shasha WEN Xin CHENG Wen(Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150081, China)

机构地区：[1]哈尔滨医科大学肿瘤医院超声科,哈尔滨150081

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第15期1191-1195,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨剪切波弹性成像(SWE)诊断结果为假阴性和假阳性甲状腺结节的二维超声及SWE特点,以提高诊断准确率。方法:选择我院就诊的189例甲状腺结节患者,共189个结节,均经手术及病理证实。记录每例患者结节的二维超声成像特点、SWE特点及术后病理结果,比较分析SWE检测为假性和真性结节的二维成像特点。结果:术后病理显示189个结节中,良性结节74个(39.2%),恶性结节115个(60.8%)。常规超声诊断甲状腺恶性结节的敏感性为56.5%、特异性为81.1%;SWE诊断甲状腺恶性结节的敏感性为60.9%、特异性为85.1%。SWE诊断良性结节的假阳性率和恶性结节的假阴性率分别为14.9%和39.1%,假阴性率高于假阳性率。纵横比>1和直径偏小(<0.5cm)均与SWE的误诊显著相关(P<0.01)。结论:SWE在鉴别甲状腺结节的良恶性中具有重要意义,但也存在漏诊或误诊,临床医生基于SWE作出诊断时,应仔细评估其二维超声特点及其他检查结果。Objective：In order to improve diagnostic accuracy, we study the characteristics of two dimensional ultrasound and shear wave elastography in the diagnosis of false negative or false positive thyroid nodules by shear wave elastography. Method：One hundred and eighty-nine nodules in 189 consecutive patients who had been deter- mined by surgical operation and pathology. Conventional ultrasound features and SWE elasticity imaging charac- teristics and properties of the final postoperative pathology were recorded. A comparative study between true and false results of quantitative SWE elasticity imaging, and the corresponding conventional ultrasound nodule charac- teristics were compared. Result.. Postoperative pathology showed 189 nodules, 74 （39.2 % ） were benign and 115 （60.8 %） were malignant. The sensitivity, specificity of conventional ultrasound in the diagnosis of thyroid nod- ules were 56.5% and 81.1% respectively, and those of SWE were 60.9% and 85.1%. The false positive rate of shear wave elastography in diagnosing benign nodules and the false negative rate of malignant nodules were 14.9 and 39. 1%,respectively. The false negative rate was higher than the false positive rate. A vertical growth（P〈 0.01） and smaller diameter of the masses（〈0.5 cm） （P〈0.01） were significantly associated with false SWE findings. Conclusion：The SWE imaging has important significance for differentiating benign and malignant thyroid nodules, but false results are inevitable, which requires clinicians conjunction with other test results to prevent er- rors judgment when reviewing the SWE imaging.

关 键 词：剪切波弹性成像 甲状腺结节 超声 

分 类 号：R581[医药卫生—内分泌]