超声造影联合弹性成像对甲状腺微小乳头状癌的诊断价值研究  

Diagnostic significance of contrast-enhanced ultrasound combined with elastography for micropapillary thyroid carcinoma

作　　者：冯蓉[1] 安丽[1] 张建蕾[2] 景磊[2] FENG Rong;AN Li;ZHANG Jian-lei;JING Lei(Department of Otorhinolaryngology—Head and Neck Surgery,Yan'an People's Hospital,Yan'an 716000,China;Department of Ultrasound Diagnosis,Yan'an People's Hospital,Yan'an 716000,China)

机构地区：[1]延安市人民医院耳鼻咽喉头颈外科,延安716000 [2]延安市人民医院超声诊断科,延安716000

出　　处：《中国肿瘤临床与康复》2020年第12期1436-1439,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：2017年陕西省延安市科技惠民计划项目(2017HM-07-06)。

摘　　要：目的探讨超声造影联合弹性成像对甲状腺微小乳头状癌的诊断价值。方法选取2018年5月至2020年5月间延安市人民医院收治的微小甲状腺占位病变患者98例(109个结节),均接受常规超声检查、超声造影和弹性成像检查,比较超声造影增强模式诊断甲状腺良恶性微小结节超声评估标准、超声造影和弹性成像与病理检查诊断甲状腺微小病变的效能。结果甲状腺良恶性微小结节(≤1cm)病理检查109个结节中,恶性结节65个,良性结节44个。超声造影增强模式低增强48个,不均匀增强29个,早期消退32个。良性结节和恶性结节的增强强度、均匀增强和早期消退指标比较,差异均无统计学意义(P>0.05)。超声造影109个结节中,恶性结节68个,良性结节41个。和病理检查比较,超声造影诊断甲状腺微小病变的敏感度为87.7%(57/65),特异度为75.0%(33/44),准确度为82.6%(90/109),阳性预测值为83.8%(57/68),阴性预测值为80.5%(33/41)。弹性成像109个结节中,恶性结节67例,良性结节42例。和病理检查相比,弹性成像诊断甲状腺微小病变的敏感度为95.4%(62/65),特异度为88.6%(39/44),准确度为92.7%(101/109),阳性预测值为92.5%(62/67),阴性预测值为92.9%(39/42)。弹性成像诊断甲状腺微小病变的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于超声造影,差异均有统计学意义(均P<0.05)。结论超声造影联合弹性成像能有效提升甲状腺微小乳头状癌的诊断敏感度和特异度,值得在临床推广应用。Objective To explore diagnostic significance of contrast-enhanced ultrasound combined with elastography for micropapillary thyroid carcinoma.Methods Ninety-eight patients(109 nodules)with micropapillary thyroid lesions were selected at Yan’an People’s Hospital from May 2018 to May 2019.Conventional ultrasound examination,contrast-enhanced ultrasonography and elastography were performed in all patients.Evaluation criteria of contrast-enhanced ultrasound for the diagnosis of benign and malignant micropapillary thyroid nodules were compared,the efficacy of contrast-enhanced ultrasound and elastography was compared for the diagnosis of small thyroid lesions.Results Among 109 benign and malignant micropapillary thyroid nodules(≤1 cm),65 were malignant and 44 were benign;Contrast-enhanced ultrasound showed 48 low enhancement,29 uneven enhancement,and 32 early regression.The enhancement intensity and uniform enhancement of benign and malignant nodules were comparable with the early regression index(P>0.05).Among the 109 nodules,68 were malignant and 41 were benign based on contrast-enhanced ultrasound.Compared with pathological examination,the sensitivity,specificity and accuracy of contrast-enhanced ultrasound for the diagnosis of micropapillary thyroid lesions were 87.7%(57/65),75.0%(33/44)and 82.6%(90/109),and the positive and negative predictive value was 83.8%(57/68)and 80.5%(33/41)respectively.In terms of elastography,among the 109 nodules,67 were malignant and 42 were benign.Compared with pathological examination,the sensitivity,specificity and accuracy of elastography for the diagnosis of micropapillary thyroid lesions were 95.4%(62/65),88.6%(39/44)and 92.7%(101/109)and the positive and negative predictive value was 92.5%(62/67)and 92.9%(39/42)respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were significantly higher for elastography than for contrast-enhanced ultrasonography(all P<0.05).Conclusion Contrast-enhanced ultrasound combined with elastogra

关 键 词：超声造影 弹性成像 甲状腺微小乳头状肿瘤 敏感度 特异度 

分 类 号：R736.1[医药卫生—肿瘤]