超声弹性成像面积比值法在甲状腺结节良恶性诊断中的应用  

Application of area ratio method of ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules

作　　者：张硕[1] 王淑文[1] 郭学敏[1] 徐虹[1] 王燕翔[1] 张霞[1] 杨莉[1] ZHANG Shuo;WANG Shuwen;GUO Xuemin;XU Hong;WANG Yanxiang;ZHANG Xia;YANG Li(Department of Ultrasound Medicine,Zhuozhou Hospital,Baoding Hebei 072750,China)

机构地区：[1]涿州市医院超声医学科,河北保定072750

出　　处：《临床与病理杂志》2022年第1期131-136,共6页Journal of Clinical and Pathological Research

基　　金：保定市科学技术研究与发展指导计划项目(17ZF247)。

摘　　要：目的:探究超声弹性成像面积比值法在甲状腺结节良恶性诊断中的应用效果。方法:回顾性分析2019年1月至2021年3月在河北省涿州市医院行甲状腺结节切除术治疗的299例患者资料,患者均于术前1周进行超声弹性成像检查。计算病灶在弹性成像图与灰阶声像图的面积比值即超声弹性成像面积比值,依据超声弹性分级对结节予以分级定性,以超声弹性1~3级为良性,4~5级为恶性,并与术后病理结果行对比分析。结果:299例患者经灰阶超声检出315个甲状腺结节,病理诊断良性结节203个,恶性结节112个。良性结节超声弹性成像面积比值为1.29±0.13,恶性结节为1.75±0.10,恶性结节的超声弹性成像面积比值高于良性结节(t=31.642,P<0.05)。术前超声弹性分级法诊断的灵敏度、特异度、准确率分别为53.57%、98.03%、82.22%;超声弹性成像面积比值≥1.51为恶性,<1.51为良性,共205个良性结节,110个恶性结节,超声弹性成像面积比值法诊断的灵敏度、特异度、准确率分别为94.64%、98.03%、96.83%,提示其诊断效能优于超声弹性分级法(Z=7.248,P<0.001)。结论:超声弹性成像面积比值法在临床甲状腺结节的良、恶性鉴别中具有较高的应用价值。Objective:To explore the application of area ratio method of ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules.Methods:This study retrospectively analyzed the data of 299 patients who underwent thyroid nodule resection in Zhuozhou Hospital between January 2019 and March 2021.All patients were subjected to ultrasound elastography at 1 week before operation,and relevant area ratios were calculated.The thyroid nodules were classified qualitatively according to ultrasound elastography classification.Ultrasound elastography grade 1 to grade 3 were defined as benign,and grade 4 to grade 5 were defined as malignant.The diagnostic results were compared with postoperative pathological results.Results:A total of 315 thyroid nodules were detected by gray-scale ultrasound in 299 patients.Pathological results showed 203 benign nodules and 112 malignant nodules.The area ratio of ultrasound elastography for benign nodules was 1.29±0.13,lower than that of malignant nodules(1.75±0.10;t=31.642,P<0.05).The diagnostic sensitivity,specificity and accuracy of preoperative ultrasound elastography classification were 53.57%,98.03%and 82.22%,respectively.When the area ratio of ultrasound elastography≥1.51 was defined as malignant and<1.51 was defined as benign,there were 205 benign nodules and 110 malignant nodules.The diagnostic sensitivity,specificity and accuracy of area ratio method of ultrasound elastography were 94.64%,98.03%and 96.83%,respectively.The diagnostic efficiency of area ratio method of ultrasound elastography was better than ultrasound elasticity classification(Z=7.248,P<0.001).Conclusion:Area ratio method of ultrasound elastography is of high application value in clinical differential diagnosis of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 超声弹性成像 面积比值法 诊断 

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]