超声造影和声脉冲成像在TI-RADS4类甲状腺结节中的诊断效果对比观察及价值研究  

Comparative Observation and Value of Contrast-enhanced Ultrasound and Acoustic Pulse Imaging in TI-RADS4 Thyroid Nodules

作　　者：吕娟[1] 张利[1] 万静[1] LYU Juan;ZHANG Li;WAN Jing(Department of Ultrasound,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang Province,830002 China)

机构地区：[1]新疆维吾尔自治区人民医院超声科,新疆乌鲁木齐830002

出　　处：《世界复合医学》2020年第2期10-12,27,共4页World Journal of Complex Medicine

基　　金：新疆自治区卫生计生委青年医学科技人才专项科研项目(WJWY-201803)。

摘　　要：目的探讨研究超声造影和声脉冲成像在TI-RADS4类甲状腺结节中的诊断效果对比观察及价值。方法选取2017年12月—2019年1月该院收治的TI-RADS4类甲状腺结节患者166例,所有患者在手术前均使用超声造影检查及声脉冲成像检查,并将所有患者的手术病理诊断结果作为对比金标准。观察所有患者的手术病理诊断结果;与病理诊断结果相比,超声造影检查与声脉冲成像检查的诊断结果及诊断效能。结果该次研究当中166例患者经手术病理证实,共存在188个甲状腺结节,其中,恶性结节:82个(43.6%),乳头状癌:78个,滤泡状甲状腺癌:4个;良性结节:106个(56.4%),结节性甲状腺肿:84个,亚急性局灶性甲状腺炎:8个,滤泡状腺瘤:6个,桥本氏结节:4个,结甲并胶原变:4个。超声造影检查共诊断出恶性结节90个,良性结节98个。声脉冲成像检查共诊断出恶性结节:89个,良性结节:99个。超声造影检查的诊断特异性为85.8%,准确性为88.3%,灵敏性为:91.5%;声脉冲成像检查的诊断特异性为87.7%,准确性为89.9%,灵敏性为:92.7%,超声造影检查与声脉冲成像检查在TI-RADS4类甲状腺结节的诊断效能方面差异无统计学意义(P>0.05)。结论在对TI-RADS4类甲状腺结节进行诊断鉴别的过程中,应用超声造影检查与声脉冲成像检查的临床效能相当;但超声造影属于有创性检查方式,建议先对患者进行声脉冲成像检查诊断;假如剪切波速度值水平位于难以分辨的临界值水平时,再对患者行超声造影检查。Objective To investigate the comparative observation and value of contrast-enhanced ultrasound and harmonic pulse imaging in the diagnosis of ti-rads4 thyroid nodules.Methods 166 cases of ti-rads4 type thyroid nodule patients admitted to our hospital from December 2017 to January 2019 were selected.All patients underwent contrast-enhanced ultrasonography and acoustic pulse imaging before operation,and the surgical pathological diagnosis results of all patients were used as the gold standard for comparison.To ob-serve the pathological diagnosis of all patients;the diagnostic results and efficacy of contrast-enhanced ultrasonography and acoustic pulse imaging were compared with pathological diagnosis.Results In this study,a total of 166 patients were confirmed by surgery and pathology to have 188 thyroid nodules,including 82 malignant nodules(43.6%),78 papillary carcinomas and 4 follicular thyroid carcinomas;benign nodules:106(56.4%),nodular goiter:84,subacute focal thyroiditis:8,follicular adenoma:6,hashimoto nodules:4,nail junction with collagen:4.A total of 90 malignant nodules and 98 benign nodules were diagnosed by ceus.A total of 89 malignant nodules and 99 benign nodules were diagnosed by acoustic pulse imaging.The diagnostic specificity,accuracy and sensitivity of ceus were 85.8%,88.3%and 91.5%respectively.The diagnostic specificity,accuracy and sensitivity of acoustic pulse imaging examination were 87.7%,89.9%and 92.7%respectively.There was no significant difference in the diagnostic efficacy of ti-rads4 thyroid nodules between ultrasound and acoustic pulse imaging examination,the difference was not statistically significant(P>0.05).Conclusion In the process of diagnosis and differentiation of TI-RADS4 thyroid nodules,the clinical efficacy of contrast-enhanced ultrasonography is comparable to that of acoustic pulse imaging.However,Ceus is an invasive examination method,so it is recommended to conduct a-coustic pulse imaging examination and diagnosis first.Ceus was performed if the shear wave velocity level

关 键 词：甲状腺结节 TI-RADS4类 超声造影 声脉冲成像 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]