超声造影对伴有钙化的甲状腺结节的诊断价值

Diagnostic value of contrast-enhanced ultrasound in calcified thyroid nodules

目的评价常规超声及超声造影在鉴别伴有钙化的甲状腺结节良恶性中的价值。方法对122例伴有钙化的甲状腺结节患者行常规超声及超声造影检查，术后均经病理证实，评估各诊断方法的灵敏性、特异性、阳性预测值、阴性预测值和诊断符合率，并用ROC曲线下面积评价常规超声、超声造影的诊断价值。结果122个伴有钙化的甲状腺结节中，良性结节73个，恶性结节49个。常规超声诊断伴有钙化的甲状腺结节良恶性的灵敏性、特异性、阳性预测值、阴性预测值、诊断符合率分别为49．98％、76．71％、58．54％、69．14％、65．57％，超声造影诊断伴有钙化的甲状腺结节良恶性的灵敏性、特异性、阳性预测值、阴性预测值、诊断符合率分别为89．80％、91．78％、88．00％、93．06％、90．98％，且与常规超声相比差异具有统计学意义。超声造影的ROC曲线下面积比常规超声的曲线下面积大，为0．908。结论超声造影对伴有钙化的甲状腺结节有较高的鉴别诊断价值。

Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound（CEUS） in calcified thyroid nodules, Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS. The sensitivity, specificity, positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated. Receiver operating characteristic（ROC） curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules. Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules. The sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98%,76.71%,58.54%,69.14% and 65.57%,while for CEUS were 89.80%,91.78%,88.00%,93.06% and 90.98%,respectively. There was statistical difference for each index between the two methods （all P〈0.05）. The area under ROC curve of CEUS was 0. 908, which was bigger than conventional ultrasound. Conclusions Compared with conventional ultrasound, CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.