超声弹性成像评级联合SR比值测定用于鉴别诊断甲状腺结节良恶性的临床价值

Clinical Value of Ultrasonic Elastography Grading Combined with Strain Ratio Measurement in Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的探讨超声弹性成像评级联合应变率比值(SR比值)测定应用于鉴别甲状腺结节良恶性的临床价值。方法对124例甲状腺肿瘤患者的175个甲状腺结节进行二维超声及超声弹性成像检查,得出结节的弹性成像评级及SR比值。据SR比值绘制ROC曲线图,结合病理检查结果确定甲状腺结节良恶性SR比值的临界点。比较二维超声与二维超声联合弹性成像评级及SR比值测定诊断甲状腺结节良恶性的准确度。结果 175个结节中良性79个,SR比值为(3.28±0.91);恶性96个,SR比值为(6.03±1.90),两组间比较差异有统计学意义(P<0.05),据SR比值绘制ROC曲线,曲线下面积为0.918,SR比值为4.03时具有最佳灵敏度(96.87%)和特异度(73.42%)。二维超声联合弹性成像评级及SR比值测定诊断结节良恶性的灵敏度、特异度、准确度分别为(92.85%、72.87%、83.72%)。均优于二维超声及二维超声联合弹性成像评级法。结论超声弹性成像评级联合SR比值有助于提高诊断甲状腺结节良恶性的准确率,在临床诊断中具有较高的应用价值。

Objective To investigate the clinical value of ultrasonic elastography grading combined with strain ratio（SR）measurement in the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 124 thyroid tumor patients with 175 thyroid nodules were subjected to conventional two-dimensional ultrasonography and ultrasonic elastography to obtain the elasticity grade and SR of nodules.According to the SR ratio,the ROC curve is plotted,and the threshold value of strain ratio in determining benign and malignant thyroid nodules was obtained based on the pathological results.The accuracy of two-dimensional ultrasonography,ultrasonic elastography grading and strain ratio measurement combined in diagnosing benign and malignant thyroid nodules was compared with that of conventional two-dimensional ultrasonography.Results Among the175 nodules,there were 79 benign nodules,with the SR being（3.28±0.91）,and 96 malignant nodules,with SR being（6.03±1.90）.Statistical difference was noted in SR between the two groups（P〈0.05）.ROC curve drawn based on SR revealed an AUC of0.918.The best sensitivity（96.87%）and specificity（73.42%）were achieved when SR was 4.03.The sensitivity,specificity and accuracy of the elasticity rating and SR combined in the diagnosis of benign and malignant nodules were 92.85%,72.87%,83.72%,respectively,which were superior to those of two-dimensional ultrasonography,and two-dimensional ultrasonography combined with ultrasonic elastography grading.Conclusion Ultrasonic elastography grading combined with SR measurement can improve the accuracy in diagnosing benign and malignant thyroid nodules,with high application value in clinical diagnosis.