彩色多普勒超声、超声弹性成像技术及US-FNB在甲状腺良、恶性结节中的诊断价值  

Diagnostic value of color Doppler ultrasound,ultrasound elastography and US-FNB in benign and malignant thyroid nodules

作　　者：李新华 杜磊 陈博 刘伯元 LI Xin-hua;DU Lei;CHEN Bo(Department of Ultrasound Medicine,Lu'an Hospital Affiliated to Anhui Medical University(Lu'an People's Hospital),Lu'an Anhui 237000,China)

机构地区：[1]安徽医科大学附属六安医院(六安市人民医院)超声医学科,安徽六安237000

出　　处：《临床和实验医学杂志》2025年第5期538-542,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学会临床研究项目(编号:2021003205)。

摘　　要：目的比较彩色多普勒超声(CDU)、超声弹性成像(UE)及超声引导细针穿刺活检(US-FNB)在甲状腺良、恶性结节中的诊断价值。方法将2021年1月至2024年5月安徽医科大学附属六安医院(六安市人民医院)收治的108例甲状腺结节患者纳入本次回顾性研究,所有患者均接受CDU、UE、US-FNB和病理学检查。分析甲状腺良、恶性结节的CDU影像学特征及UE评分情况;比较3种检查方法与病理检查结果的一致性,及3种检查方法在甲状腺良、恶性结节诊断中的效能。结果108例甲状腺结节患者中,术后病理检查结果显示,恶性结节占比58.33%(63/108),良性结节占比41.67%(45/108)。CDU检查显示,恶性结节的主要特征是血流丰富、纵横比≥1、微小钙化、形态不规则、边界毛糙、内部低或极低回声和血流阻力指数≥0.7,诊断恶性结节53个、良性结节55个。恶性结节的UE弹性评分0~4分分别为0、5(7.94%)、7(11.11%)、30(47.62%)、21(33.33%),诊断恶性结节57个、良性结节51个。CDU与病理检查结果的一致性尚可(Kappa值=0.557),UE与病理检查结果的一致性良好(Kappa值=0.668);US-FNB与病理检查结果高度一致(Kappa值=0.852)。CDU检查的敏感度、特异度、准确率分别为73.02%、84.44%、77.78%;UE的敏感度、特异度、准确率分别为80.95%、86.67%和83.33%,US-FNB的敏感度、特异度、准确率最高,分别为92.06%、93.33%和92.59%。结论在甲状腺良、恶性结节诊断时,CDU、UE及US-FNB这3种检查中,US-FNB与病理检查结果高度一致,且敏感度、特异度和准确率最高。Objective To compare the value of color Doppler ultrasonography(CDU),ultrasonic elastography(UE),and ultrasound-guided fine needle biopsy(US-FNB)in diagnosing benign and malignant thyroid nodules.Methods A total of 108 patients with thyroid nodules admitted to Lu'an Hospital Affiliated to Anhui Medical University(Lu'an People's Hospital)from January 2021 to May 2024 were included in this retrospective study,all of whom underwent CDU,UE,US-FNB,and pathological examination.CDU imaging characteristics and UE score of benign and malignant thyroid nodules were analyzed,and the consistency between three methods and pathological examination were compared,and the diagnostic efficiency of the three methods in benign and malignant thyroid nodules were evaluated.Results Among the 108 cases of thyroid nodules,pathological examination showed that malignant nodules accounted for 58.33%(63/108)and benign nodules accounted for 41.67%(45/108).CDU showed that the main features of malignant nodules were abundant blood flow,aspect ratio≥1,microcalcifications,irregular morphology,rough boundaries,low or extremely low internal echoes,and resistance index≥0.7.Fifty-three malignant nodules and 55 benign lesions were diagnosed by CDU.The UE elasticity scores of malignant nodules from 0 to 4 were 0,5(7.94%),7(11.11%),30(47.62%),and 21(33.33%),respectively.Fifty-seven malignant nodules and 51 benign nodules were diagnosed by UE.The consistency between CDU and pathological examination results was acceptable(Kappa value of 0.557),while the consistency between UE and pathological results was good(Kappa value=0.668).US-FNB was highly consistent with pathological results(Kappa value=0.852).CDU had the sensitivity of 73.02%,specificity of 84.44%,and accuracy of 77.78%,respectively.UE had the sensitivity of 80.95%,specificity of 86.67%,and accuracy of 83.33%while US-FNB had the highest sensitivity of 92.06%,highest specificity of 93.33%,and highest accuracy of 92.59%respectively.Conclusion In the diagnosis of benign and malignant thyroid nodu

关 键 词：彩色多普勒超声 甲状腺肿瘤 诊断 超声弹性成像技术 超声引导细针穿刺活检 

分 类 号：R736.1[医药卫生—肿瘤]