三维声弹性成像在甲状腺结节诊断中的初步应用

A preliminary study of three-dimensional elastosonography in diagnosis of thyroid nodules

目的探讨三维声弹性成像在甲状腺结节诊断中的应用价值。方法选取于复旦大学附属中山医院诊治的34例甲状腺结节患者,依次进行灰阶超声、彩色多普勒超声、二维声弹性成像和三维声弹性成像检查。根据三维声弹性图表现,将病灶的弹性分级分为Ⅰ~Ⅳ级,并与病理结果对比。结果良性病变以Ⅰ~Ⅱ级多见,恶性病变以Ⅲ~Ⅳ级多见,良性病变与恶性病变声弹性图的分布差异具有统计学意义（P〈0.05）。以Ⅲ级以上（含Ⅲ级）作为判断恶性的标准,灵敏度为94.4%,特异度为81.3%,准确率为88.2%。结论三维声弹性成像对甲状腺结节的诊断能提供一定帮助。

Objective To investigate the value of three-dimensional elastosonography in the diagnosis of thyroid lesions.Methods The three-dimensional elastograms of 34 thyroid nodules in 34 patients were analyzed and classified into grades Ⅰ to Ⅳ, with pathology as the reference standard. The lesions with grade Ⅲ or grade Ⅳ were diagnosed as malignancy. Results Most benign nodules were grades Ⅰ and Ⅱ, while thyroid malignancies were grades Ⅲ and Ⅳ. There was significant difference in elastographic grade between the two groups （P〈0.05）. If thyroid nodules with grade Ⅲ or grade Ⅳ were diagnosed as malignant, the sensitivity, specificity and accuracy of three-dimensional elastosonography were 94.4%, 81.3% and 88.2%, respectively.Conclusion Three-dimensional elastosonography is helpful for the diagnosis of thyroid diseases.