超声弹性成像技术在甲状腺结节诊断中的应用价值  

Diagnostic value of ultrasound elastography in benign and malignant thyroid nodules

作　　者：罗俊 王刚 Luo Jun;Wang Gang(Department of Ultrasound,the First People's Hospital of Linhai,Linhai,Zhejiang 317000,China)

机构地区：[1]临海市第一人民医院超声科,浙江省317000

出　　处：《中国基层医药》2020年第18期2196-2200,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察超声弹性成像技术在甲状腺结节诊断中的应用价值。方法选择2017年1月至2018年12月至临海市第一人民医院进行甲状腺结节检查的患者150例进行临床研究。患者均给予常规甲状腺超声检查和甲状腺超声弹性成像检查。以病理检查结果为最终诊断结果,观察常规超声和超声弹性成像诊断甲状腺恶性肿瘤的敏感性和特异性。按照病理检查结果将患者分为良性组和恶性组,观察两组患者常规超声和超声弹性评分情况。结果常规超声诊断甲状腺恶性结节的灵敏度为59.46%(22/37),特异度为83.19%(94/113)。超声弹性成像诊断甲状腺恶性结节灵敏度为94.59%(35/37),特异度为97.35%(110/113)。超声弹性成像诊断灵敏度和特异度均高于常规超声,差异均有统计学意义(χ2=12.906,P=0.000;χ2=12.891,P=0.000)。在常规超声中,恶性结节回声不均匀、边界不清晰、形态不规则所占比例均明显高于良性结节,且差异均有统计学意义(χ2=52.316,P=0.000;χ2=50.532,P=0.000;χ2=68.772,P=0.000),两者结节周边声晕情况差异无统计学意义(χ2=0.757,P=0.384),恶性甲状腺结节超声弹性成像评分以4分为主,占45.95%,良性甲状腺结节超声弹性成像评分以1分、2分为主,分别为32.74%、52.21%。两组评分差异有统计学意义(χ2=66.327,P=0.000)。结论超声弹性成像在甲状腺良恶性结节诊断中具有重要的应用价值,能够提高诊断的敏感性和特异性。Objective To analyze the diagnostic value of ultrasound elastography in benign and malignant thyroid nodules.Methods From January 2017 to December 2018,150 patients who underwent thyroid nodule examination in the First People's Hospital of Linhai were randomly selected in this study.All patients received routine thyroid ultrasonography and thyroid ultrasound elastography.The sensitivity and specificity of routine examination and elastic ultrasonography in the diagnosis of thyroid malignant tumors were observed.The patients were divided into benign group and malignant group according to the results of pathological examination.The scores of routine ultrasound and elastic ultrasound were observed in both two groups.Results The sensitivity and specificity of gray scale ultrasound in the diagnosis of thyroid malignant nodules were 59.46%(22/37)and 83.19%(94/113),respectively,which were significantly lower than those of ultrasound elastography[94.59%(35/37)and 97.35%(110/113).],and there were statistically significant differences(χ2=12.906,P=0.000;χ2=12.891,P=0.000).In gray-scale ultrasound,the proportions of non-uniform echo,unclear boundary and irregular shape of malignant nodules were significantly higher than those of benign nodules(χ2=52.316,P=0.000;χ2=50.532,P=0.000;χ2=68.772,P=0.000).There was no statistically significant difference in the rhythm around the nodules between the two groups(χ2=0.757,P=0.384).The score of ultrasound elastography of malignant thyroid nodules was mainly 4 points(45.95%),and that of benign thyroid nodules was mainly 1 point and 2 points(32.74%and 52.21%).The score between the two groups was statistically significant difference(χ2=66.327,P=0.000).Conclusion Ultrasound elastography has important application value in the diagnosis of benign and malignant thyroid nodules,and can improve the sensitivity and specificity of diagnosis.

关 键 词：超声检查 多普勒 彩色 弹性成像技术 甲状腺结节 常规超声 结节回声 甲状腺峡部 甲状腺下极 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]