二维超声与弹性成像对甲状腺良恶性结节诊断的对比研究

Comparative study of two-dimensional ultrasound and elastography in differential diagnosis of malignant and benign thyroid nodules

目的探讨二维超声和超声弹性成像鉴别甲状腺结节良恶性的效能和互补性。方法对98例甲状腺结节患者的129个病灶先后进行二维超声和弹性成像检查,分别计算二维超声具有不同恶性特征数与弹性成像各个分级情况下的敏感性和特异性;绘制两种方法诊断甲状腺恶性结节的ROC曲线,比较其诊断价值。结果二维超声ROC曲线下面积为0.865,弹性成像ROC曲线下面积为0.938,两种方法经Z检验,Z值=1.268,P=0.2049,提示二者差异无统计学意义。结论本组病例提示二维超声与弹性成像均能对甲状腺结节的良恶性做出准确判断,两种方法诊断效能相当,在实际工作中应正确认识弹性成像是在二维超声基础上叠加的硬度信息,需要二者结合综合考虑才能提高对甲状腺结节的诊断水平。

Objective To explore the efficacy and complementarity of two - dimensional ultrasound and elastography in differential diagnosis of malignant and benign thyroid nodules. Methods Ninety - eight patients with 129 thyroid nodules were examined by two - dimensional ultrasound and tissue elastography. Sensitivity and specificity of the two methods in diagnosis of malignant nodules were calculated according to the malignant characteristics of two - dimensional ultrasound and classification of elastography. Then receiver operative characteristic（ROC） curve of the two methods was drawn and diagnostic value of the two methods was compared. Results The areas under ROC curve of two - dimensional ultrasound and real - time elastography were 0. 865 and 0. 938, respectively. Z value = 1. 268, P = 0. 2049, there was no significant difference between the two methods. Conclusion Both two -dimensional ultrasound and real -time elastography can make effective diagnosis in preliminary assessment of malignant and benign thyroid nodules. The information of tissue stiffness in elastography imaging is added on the base of two - dimensional uhrasonography. We should take the information of both the two methods to improve the diagnostic rate.