超声弹性成像与常规超声在甲状腺结节诊断中的对比研究

Comparative study of ultrasound elastography and conventional ultrasound in the diagnosis of thyroid nod-ules

目的：探析超声弹性成像技术应用于临床甲状腺结节诊断中的价值和意义。方法回顾性分析经手术病理证实的138例甲状腺结节患者（160个结节）术前的影像学资料，对比分析术前常规超声与超声弹性成像特征，并与病理结果对照，评价超声弹性成像在临床诊断甲状腺结节中的应用价值和意义。结果该组138例甲状腺患者160个结节中病理证实为良性129个（80.63％），恶性31个（19．38），根据超声弹性成像所得的弹性图颜色分级标准，129个良性结节中0～Ⅱ级113个（86．82％）、Ⅲ～Ⅳ级16个（13．18％）；31个恶性结节中0～Ⅱ级4个（12．90％）、Ⅲ～Ⅳ级27个（87.10％）。常规超声诊断符合率为66．25％，明显小于超声弹性成像的87．50％（χ2＝20．32， P＝0．000），常规超声检查特异度为61．29％、灵敏度为67．44％、阳性预测值为87．88％、阴性预测值为31．15％，均明显低于超声弹性成像的87．10％、87．60％、96．58％、62．79％（χ2＝15．04，P＝0．000；χ2＝5．39，P＝0．022；χ2＝5．92，P＝0．019；χ2＝10．24，P＝0．001）。结论超声弹性成像技术与常规超声相比对甲状腺良、恶性结节的鉴别诊断能力具有明显的优势，能早期对甲状腺结节确诊，具有十分重要的临床应用价值，值得广泛推广并应用于临床诊断。

Objective To explore the clinical value and significance of elastography technique used in the diagnosis of thyroid nodules .Methods The preoperative imaging data of pathologically confirmed 138 patients with thyroid nodules（160 nodules） were retrospectively analyzed .The imaging characteristics of routine preoperative ultra-sound and elastography were compared and the results were compared with the histopathological findings ,thus to eval-uate the clinical value of elastography in the diagnosis of thyroid nodules .Results Of 160 thyroid nodules in 138 pa-tients,129 nodules （80.63%） were histologically confirmed benign ,31 nodules （19.38%） were confirmed malig-nant.According to the elastic graph color grading standards of ultrasound elastography , in 129 benign nodules,＆nbsp;113 nodules （86.82%） were 0~Ⅱ grade,16 nodules（13.18%） wereⅢ~Ⅳ grade.Of 31 malignant nodules,4 nodules （12.90%） were 0~Ⅱgrade,27 nodules （87.10%） wereⅢ~Ⅳgrade.The diagnosis coincidence rate of conventional ultrasound was 66.25%,which was significantly lower than 87.50%of elastosonography （χ2 =20.32, P=0.000）.The specificity,sensitivity,positive predictive value and negative predictive value of routine ultrasound were 61.29%,67.44%,87.88%,31.15%,which were significantly lower than those of ultrasound elastography （87.10%,87.60%,96.58%,62.79%）（χ2 =15.04,P=0.000;χ2 =5.39,P=0.022;χ2 =5.92,P=0.019;χ2 =10.24,P=0.001）.Conclusion Compared with conventional ultrasound ,ultrasound elastography technique has ob-vious advantages in the differential diagnosis of benign and malignant thyroid nodules ,which has very important clini-cal value and should be popularized and applied in clinical diagnosis .