常规超声联合超声造影在鉴别诊断慢性淋巴细胞性甲状腺炎合并甲状腺实性结节中的价值

Diagnostic Value of Contrast-enhanced Ultrasonography Combined with Conventional Ultrasound in Benign and Malignant Solitary Thyroid Nodules with Chronic Lymphocytic Thyroiditis

目的 通过研究常规超声联合超声造影在鉴别诊断慢性淋巴细胞性甲状腺炎合并甲状腺实性结节的价值,提高术前诊断的准确率.方法 以2013年1月～2014年8月在舟山医院经手术病理证实的80例慢性淋巴细胞性甲状腺炎患者108个甲状腺实性结节为研究对象,分析比较其术前常规超声图像表现及超声造影表现,并以病理结果为金标准绘制ROC曲线,评价常规超声联合超声造影在慢性淋巴细胞性甲状腺炎合并甲状腺实性结节鉴别诊断中的价值.结果 边界、纵横比、回声、钙化、血流分布、不均匀增强及增强强度7个超声影像特征对诊断恶性结节有较大的参考价值,联合7项超声影像特征诊断的敏感度为87.1％,特异性为84.8％,准确度为86.1％.结论 常规超声联合超声造影对评估慢性淋巴细胞性甲状腺炎合并甲状腺实性结节良恶性有一定的价值,能明显提高诊断的准确率.

Objective To improve the accuracy of preoperative diagnosis of conventional ultrasound combined with contrast - en- hanced ultrasound （CEUS） in the differential diagnosis of thyroid solid nodules with chronic lymphocytic thyroiditis （CLT）. Methods Totally 108 thyroid solid nodules with CLT were examed by conventional ultrasound and contrast- enhanced ultrasound, which were con- firmed by surgical pathology in Zhoushan Hospitat, and there preoperative ultrasound images were revewed. A receiver operator charaeteris （ROC） curve was constructed to assess the performance. Results Seven uhrasonographic features including margin, aspect ratio, echo, calcification, blood ditribution, heterogeneous enhancement and peak intensity were valuable in the diagnosis of malignant thyroid solid nodule with CLT. When combination of the seven parameters were used for the diognosis of malignant thyroid solid nodules with CLT, the percentage of correct prediction, the sensitivity and specificity were 86.1% , 87.1% , 84.8% , respectively. Conclusion Conventional uhrasoud combined with contrast - enhanced ultrasound were valuable in the differential diagnosis of benign and malignant thyroid solid nodule, and improved the accuracy of preoperative diagnosis.