超声造影和超声弹性成像鉴别诊断甲状腺良恶性结节的价值

Value of Ultrasound Imaging and Ultrasound Elastography in Diagnosing Thyroid Malignant and Benign Nodules

目的:评价超声造影和超声弹性成像在甲状腺良恶性结节中的鉴别诊断价值方法:对164个经手术病理证实的甲状腺良恶性结节的超声造影和弹性成像特征进行对比分析,评估两种诊断方法的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率。结果:164个甲状腺结节中,良性病灶96个,恶性病灶68个良性结节在注射造影剂后均早于周围腺体增强,晚于周围腺体廓清,多数结节表现为周边环状增强,恶性结节大多以低增强为主,增强回声不均匀,早于周边甲状腺组织消退超声造影的灵敏度、特异度、阳性预测值及阴性预测值分别为91.18%、93.75%、91.18%及93.75%;弹性成像的灵敏度、特异度、阳性预测值及阴性预测值分别为88.24%、91.67%、88.24%及91.67%:两者联合诊断的灵敏度、特异度、阳性预测值及阴性预测值分别为97.06%、85.42%、82.50%及97.62%。结论:超声造影和弹性成像对甲状腺良恶性结节有较高的鉴别诊断价值,两者联合可提高对该病的诊断率。

Objective： This study aims to evaluate ultrasound imaging and ultrasound elastography of benign and malignant thyroid nodules in the differential diagnosis. Methods： A total of 164 benign and malignant thyroid nodules confirmed using pathology, ultrasound contrast, and elasticity imaging characteristics were analyzed to assess the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate. Results： The 164 thyroid nodules included 96 benign lesions and 68 malignant lesions. After the injection of contrast medium, the benign nodules enhanced the surrounding glands later than the peripheral gland dissection. Majority of the nodules exhibited peripheral ring enhancement. The malignant nodules were mostly low-enhanced and uneven enhanced echo as early as the dissipation of the surrounding thyroid tissue. The contrast sensitivity, specificity, positive predictive value, and negative predictive values of ultrasound were 91.18%, 93.75%, 91.18%, and 93.75%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive values of elastrography were 88.24%, 91.67%, 88.24%, and 91.67%, respectively. The contrast sensitivity, specificity, positive predictive value, and negative predictive values of ultrosound combined with elastography were 97.06%, 85.42%, 82.50%, and 97.62%, respectively. Conclusion： Ultrasound imaging and elastography have a high value for differential diagnosis of benign and malignant thyroid nodules, and the combination of the two methods can improve the diagnosis rate.