实时超声弹性成像对甲状腺实性结节的诊断价值

Diagnostic value of real-time ultrasound elastography in thyroid solid nodules

目的探讨实时超声弹性成像对甲状腺实性结节的诊断价值。方法回顾性分析123个结节的甲状腺常规超声及弹性成像图像特征，并与病理结果进行对照。结果84个结节病理诊断结果为良性，39个结节病理诊断结果为恶性。与良性甲状腺结节比较，恶性甲状腺结节超声中边界不清、形态不规则；纵横比〉1者。微钙化者和弹性分级Ⅲ～Ⅳ级者多（P〈0．01）。良性结节中，80个结节（95．2％）弹性分级为0～II级；恶性结节中，37个结节（94．9％）弹性分级为Ⅲ～Ⅳ级。良恶性结节分级差别在Ⅰ、Ⅱ、Ⅲ、Ⅳ级上差异有统计学意义（χ2=98．583，P〈0．0i）。以0～II级判断为良性，Ⅲ～Ⅳ级判断为恶性，两组弹性分级比较，差异有统计学意义（χ2=91．319，P〈0．01），其在甲状腺结节鉴别诊断中的敏感度、特异度、准确度分别是94．9％、95．2％、95．1％。结论实时超声弹性成像对甲状腺实性结节有较高的鉴别诊断价值。

Objective To evaluate the diagnostic value of real-time ultrasound elastography in thyroid solid nodules. Methods A retrospective analysis of 123 thyroid nodules were confirmed by operation and pathology,whose characteristics of conventional ultrasound imaging and real-time ultrasound elastography imaging were analyzed retrospectively. Results Eighty-four solid nodules had final diagnoses of benign nodules based on histopathological examination,while 39 solid nodules were diagnosed as malignant ones. Compared with benign thyroid nodules, illdefined margins, irregular shape, anteroposterior/transverse diameter more than 1 cm, microcations and Elasticity grade III or IV were highly predictive of malignant nodules（ P 〈.0.01）. In real-time ultrasound elastography results, 80 nodules（95.2%） were grade 0-II of all benign nodules,and 37 nodules（94.9%） were grade III-IV of all malignant nodules. There were statistical difference in elasticity grade（χ2 = 98. 583, P 〈0.01）. Elasticity grade III or IV was highly predictive of malignancy（χ2 = 91.319, P 〈0.01 ）, with the sensitivity of 94.9 %, specificity 95.2 %, accuracy of 95.1%. Conclusion Real-time ultrasound elastography has higher value in differential diagnosis of benign and malignant thyroid solid nodules.