超声造影在具有可疑特征的甲状腺良性结节中的鉴别诊断价值  

Differential diagnostic value of ultrasonography in benign thyroid nodules with suspicious features

作　　者：丁姣姣[1] 庄晓晨 苟政江 王晓荣[1] 高军喜[1] 宋涛[1] DING Jiaojiao;ZHUANG Xiaochen;GOU Zhengjiang;WANG Xiaorong;GAO Junxi;SONG Tao(Department of Abdominal Ultrasound,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院腹部超声诊断科,新疆乌鲁木齐830054

出　　处：《医学影像学杂志》2025年第3期31-35,共5页Journal of Medical Imaging

基　　金：新疆维吾尔自治区卫生健康扶贫工作优秀适宜技术推广项目(编号:SYTG-Y202027)。

摘　　要：目的 探讨超声造影(contrast-enhanced ultrasound,CEUS)对具有超声可疑特征的甲状腺良性结节的鉴别诊断价值。方法 选取超声检查具有可疑特征并取得病理结果的甲状腺结节患者784例。根据手术病理结果分为甲状腺乳头状癌(papillary thyroidcarcinoma,PTC)组和良性结节组,应用倾向性评分匹配(propensity score matching,PSM)均衡PTC组和良性组之间协变量的分布,成功配对240个结节。筛选组间临床特征、常规超声检查与CEUS特征的差异指标,建立回归方程,绘制ROC曲线得出最佳cut-off值、敏感度与特异度。结果 Logistic多因素分析结果显示年龄、结节大小、钙化情况、血流类型、CEUS增强速度与增强模式最终被纳入方程,方程总体诊断准确率为80.00%。ROC曲线下面积为0.870,敏感度79.00%,特异度81.00%。结论 CEUS特征对具有可疑特征的甲状腺良性结节的鉴别诊断有重要价值。Objective To investigate the differential diagnostic value of contrast-enhanced ultrasound(CEUS)for benign thyroid nodules with suspicious ultrasound features.Methods A total of 784 cases of thyroid nodules with suspicious features on ultrasonography and pathologic results were retrospectively studied.They were divided into papillary thyroid carcinoma(PTC)group and benign nodule group according to the surgical pathological results,and propensity score matching(PSM)was applied to equalize the distribution of covariates between the PTC group and the benign group,and 240 nodules were successfully paired.Indicators of differences in clinical features,conventional ultrasound and CEUS features between groups were screened,regression equations were established,and ROC curves were plotted to derive the optimal cut-off value,sensitivity and specificity.Results Logistic multifactorial analysis showed that age,nodule size,calcification,blood flow type,wash in invelocity and en-hancement pattern were finally included in the equation,and the overall diagnostic accuracy of the equation was 80.00%.The area under the ROC curve was 87.00%,with a sensitivity of 79.00%and a specificity of 81.00%.Conclusion CEUS features are valuable in the differential diagnosis of benign thyroid nodules with suspicious features,with great clinical benefit.

关 键 词：超声检查 可疑特征 良性结节 鉴别诊断 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]