常规超声联合超声造影诊断部分囊性甲状腺结节良恶性的价值  

Conventional Ultrasound Combined with Contrast-Enhanced Ultrasound in the Diagnosis of Benign and Malignant Cystic Thyroid Nodules

作　　者：宋青[1,2] 田晓琦 兰雨 张颖[1] 张艳[1] 朱亚琼[1] 罗渝昆[1] SONG Qing;TIAN Xiaoqi;LAN Yu;ZHANG Ying;ZHANG Yan;ZHU Yaqiong;LUO Yukun(Department of Ultrasound,the First Medical Center of General Hospital of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声诊断科,北京100853 [2]解放军总医院第七医学中心超声科,北京100700

出　　处：《中国医学影像学杂志》2020年第3期189-193,共5页Chinese Journal of Medical Imaging

基　　金：北京市科技计划课题(Z181100001718017);北京市自然科学基金(7194318);原陆军总医院创新培育基金项目(2015-LC-05)。

摘　　要：目的研究常规超声联合超声造影对部分囊性甲状腺结节(PCTN)良恶性的鉴别诊断价值。资料与方法回顾性分析47例恶性PCTN患者共50枚结节的临床及超声图像;选取同时期经病理证实为良性PCTN患者88例共109枚结节。比较两组常规超声及超声造影图像特征,包括结节成分、边界、血流、晕环、钙化,实性部分回声、形态等。结果与良性PCTN比较,恶性PCTN病灶的成分、边界、是否存在微小钙化及实性成分的回声、形态、超声造影增强均匀度差异均有统计学意义(P<0.05)。常规超声联合超声造影对PCTN的诊断敏感度、特异度、阳性预测值、阴性预测值及准确度分别为96.3%、90.2%、89.0%、74.0%、89.3%,常规超声的上述指标分别为82.2%、58.0%、89.0%、70.7%、79.2%,其中特异度、阴性预测值及准确度与常规超声联合超声造影比较,差异均有统计学意义(P<0.05)。结论常规超声联合超声造影对甲状腺PCTN的良恶性具有鉴别诊断价值,有助于提高恶性PCTN的诊断准确率。Purpose To study the value of conventional ultrasound combined with contrast-enhanced ultrasound in the differential diagnosis of benign and malignant partial cystic thyroid nodule(PCTN). Materials and Methods The clinical and ultrasound images of 50 nodules from 47 patients with malignant PCTN were retrospectively analyzed. A total of 109 nodules from 88 patients with benign PCTN confirmed by pathology at the same time were selected. Features of conventional ultrasound and contrast-enhanced ultrasound images, including nodule composition, border, blood flow, halo, calcification, echo and morphology of solid parts, were compared between the two groups. Results Compared with benign PCTN, there were statistically significant differences in the composition, boundary, echo, morphology and contrastenhanced homogeneity of the lesions of malignant PCTN lesions(P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of conventional ultrasound combined with contrast-enhanced ultrasound for PCTN were 96.3%, 90.2%, 89.0%, 74.0% and 89.3%, respectively;the above indicators for conventional ultrasound were 82.2%, 58.0%, 89.0%, 70.7% and 79.2%, respectively, the specificity, negative predictive value and accuracy were statistically significant than those of conventional ultrasound combined with contrastenhanced ultrasound(P<0.05). Conclusion Routine ultrasound combined with contrast-enhanced ultrasound has a differential diagnosis value for benign and malignant thyroid PCTN, and it is helpful to improve the diagnostic accuracy of malignant PCTN.

关 键 词：甲状腺结节 甲状腺肿瘤 超声检查 多普勒 彩色 造影剂 病理学 外科 诊断 鉴别 

分 类 号：R730.41[医药卫生—肿瘤] R581.3[医药卫生—临床医学]