超声造影、弹性成像鉴别甲状腺恶性结节的敏感度研究

Study on the Sensitivity of Contrast-Enhanced Ultrasound and Elastography in Distinguishing Malignant ThyroidNodules

目的探讨超声造影、弹性成像鉴别甲状腺恶性结节的敏感度。方法回顾性分析2018年12月—2019年12月在四川省攀枝花市中西医结合医院进行手术治疗,病理学确诊的164例甲状腺结节患者的超声造影、弹性成像鉴别资料,比较分析两种鉴别方式的灵敏度、特异性、阴阳预测数值以及诊断符合情况。结果164例甲状腺结节患者诊断中96例患者诊断为良性病变,68例患者诊断为恶性病变;另96例良性病变患者注射造影剂后信号增强早于周围腺体,但是信号增强晚于周围腺体,大部分结节表现出周围环状信号增强,恶性结节大部分以低信号增强为主,增强回声不均匀,显示消退时间早于周边甲状腺组织。超声造影的灵敏度、特异性、阳性预测及阴性预测数值为:91.2%、93.8%、91.2%、93.8%、92.6%,而弹性成像诊断的灵敏度、特异性、阳性预测及阴性预测数值为:88.2%、91.7%、88.2%、91.7%、90.2%,两者联合诊断的灵敏度、特异性、阳性预测及阴性预测数值为97.1%、85.4%、82.5%、97.6%、90.2%。结论超声造影与弹性成像鉴别在甲状腺恶性结节诊断中具有积极意义,但是单一诊断方案尚有一定不足,两者联合诊断可弥补对方缺陷,提升整体诊断准确性,为甲状腺结节患者提供可靠的临床诊断依据。

Objective To explore the sensitivity of contrast-enhanced ultrasound and elastography in distinguishing malignant thyroid nodules.Methods Retrospective analysis of 164 cases of thyroid nodules diagnosed by pathology from December 2018 to December 2019 was conducted.The sensitivity and specificity of the two methods were compared and analyzed.Sex,yin and yang predictions,and diagnostic compliance.Results Among the 164 patients with thyroid nodules,96 patients were diagnosed with benign lesions and 68 patients were diagnosed with malignant lesions.The other 96 patients with benign lesions had signal enhancement earlier than peripheral glands after contrast injection,but the signal enhancement was later than peripheral In the gland,most of the nodules showed an increase in peripheral ring signals.Most of the malignant nodules were mainly low-signal enhancements,with uneven enhancement of echo,showing that the regression time was earlier than that of peripheral thyroid tissue.The sensitivity,specificity,positive predictive and negative predictive values of contrast-enhanced ultrasound are:91.2%,93.8%,91.2%,93.8%,92.6%,and the sensitivity,specificity,positive predictive and negative predictive values of elastography diagnosis are:88.2%,91.7%,88.2%,91.7%,90.2%.The sensitivity,specificity,positive prediction and negative prediction of the combined diagnosis were 97.1%,85.4%,82.5%,97.6%,90.2%.Conclusion The difference between contrast-enhanced ultrasound and elastography has a positive significance in the diagnosis of malignant thyroid nodules,but there is still a certain shortco ming in the single diagnosis scheme.The combined diagnosis of the two can make up for each other's defects,improve the overall diagnosis accuracy,and provide reliable for patients with thyroid nodules.