灰阶超声联合超声弹性成像在甲状腺良恶性结节鉴别诊断中的应用价值

Evaluation of grey scale ultrasonography combined with elastography in differentiating benign and malignant thyroid lesions using receiver operating characteristic curves

目的 评价灰阶超声联合超声弹性成像技术在甲状腺良恶性结节鉴别诊断中的应用价值.方法 经病理证实的81个甲状腺结节术前均行灰阶超声成像及超声弹性成像检查,根据结节的超声特征及弹性成像特征,与病理结果进行比较,分别绘制灰阶超声检查及灰阶超声联合超声弹性成像2种方法的ROC曲线,比较曲线下面积.结果 灰阶超卢组最佳诊断界点为5分,敏感性与特异性分别为60.0%,98.5%;联合诊断组最佳诊断界点为6分,灵敏度与特异度分别为80.0%、89.4%.灰阶超声组、联合诊断组ROC曲线下面积分别为0.860、0.916,两组曲线下面积差异有统计学意义（Z=-7.863,P=0.000）.结论 在灰阶超声榆查的基础上联合超卢弹性成像进行综合分析,可以提高诊断的敏感性,降低漏诊率,有助于甲状腺结节的良恶性鉴别.

Objective To evaluate the value of grey scale ultrasonography （US） combined with elastography in the difference diagnosis of benign and malignant thyroid lesions. Methods Sixty-two patients with 81 lesions were examined by grey scale US and elastography preoperatively. All the lesions were confirmed by pathology. According to their features of grey scale ultrasonograms and elastograms, two receiver operating characteristic （ROC） curves were drawn, one for gray ultrasound and one for the combination methods. The area under curve （AUC） of them were made a comparison. Results The cut-off value of the grey scale group was equal or more than 5, the sensitivity,specificity was 60. 0% ,98. 5%. And the cut-off value of grey scale US combined with elastography group was equal or more than 6, the sensitivity, specificity was 80.0%, 89.4%. The AUC of grey scale US was 0.860 and that of the combination group was 0. 916. The difference between them was statistically significant Z = - 7. 863, P = 0. 000）. Conclusions The grey scale US combined with elastography could improve sensitivity and decrease omission diagnose rate. It may be more helpful in the difference diagnosis of malignant from benign thyroid lesions.