甲状腺结节的超声弹性成像与病理检查结果对照研究

Value of ultrasonic elastography in diagnosis of malignant thyroid nodules

目的研究超声弹性成像在甲状腺结节临床诊断中的意义。方法对50例患者的66个甲状腺结节进行超声弹性成像检测,将检查结果与病理检查结果进行对照研究。结果 (1)超声弹性成像的灵敏度、特异度、诊断准确率分别为78.95%、76.60%、77.27%。(2)弹性成像评分与恶性结节比例呈正相关(r=0.899,P<0.05)。(3)不同大小的结节中恶性结节的百分比分别是47.37%[甲状腺结节长径(L)≤1cm]、15.79%(1cm<L≤2cm)、30.00%(2cm<L≤3cm)、14.29%(3cm<L≤4cm)、33.33%(L>4cm),组间比较无统计学差异(P>0.05)。(4)不同大小结节的弹性成像评分分别是(2.53±1.02)分(L≤1cm)、(2.26±1.24)分(1cm<L≤2cm)、(1.80±1.32)分(2cm<L≤3cm)、(1.86±1.22)分(3cm<L≤4cm)、(2.44±0.73)分(L>4cm),组间比较无统计学差异(P>0.05)。(5)良性结节弹性成像评分(1.72±0.97)分,恶性结节弹性成像评分(3.26±0.80)分,组间比较有统计学差异(P<0.01)。结论弹性成像评分≥3分对预测恶性甲状腺结节有一定的临床价值。

Objective To evaluate the application of ultrasonic elastography （USE） in diagnosis of malignant thyroid nodules. Methods Fifty patients with thyroid nodules （66 nodules） underwent ultrasonic elastography examination from April 2013 to April 2014. Using pathological results as gold standard the diagnostic value of USE for malignant thyroid nodule was e- valuated. Results The sensitivity, specificity and accuracy of ultrasound elastography for malignant nodule was 78.95%, 76.0% and 77.27%. The elastic score was positively correlated with malignant nodules（r=0.899, P〈0.05）. The positive malignant rates as diagnosed by USE in thyroid nodules of different sizes were 47.37% （L≤1cm）, 15.79% （1cm〈L≤2cm）, 30.00% （2cm〈L≤3cm）, 14.29% （3cm〈L≤4cm）, 33.33% （L〉4cm）, there was no significant difference in positive rate among nodules with different size （P〉0.05）. The elasticity scores for nodules of different sizes were （2.53 ± 1.02） points （L≤ lcm）, （ 2.26 ± 1.24） points （1cm〈L≤ 2cm）, （1.80 ±1.32） points （2cm〈L≤3cm）, （1.86 ± 1.22） points （3cm〈L≤4cm）, （2.44 ± 0.73） points （L〉4cm）, there was no sig- nificant difference in elasticity scores among nodules with different size（P〉0.05）. The average elasticity scores in malignant nod- ules were significantly higher than those in benign nodules （3.26 ± 0.80 vs 1.72± 0.97, P〈0.01）. Conclusion The cut-off value of elasticity score/〉3 points in ultrasonic elastography might be used for diagnosis of malignant thyroid nodules clinically.