超声弹性成像在甲状腺良恶结节中的应用价值及影响因素

目的 研究分析超声弹性成像诊断甲状腺良恶性结节的价值和影响因素.方法 选取我院2013 年4 月至2014 年5 月收治的40 例甲状腺患者,有56 个甲状腺结节,针对所有患者采取超声弹性成像和常规超声特征检查,所有病例均由手术病理证实.其中根据结节病灶的大小分为〈1cm、1-2cm、2-3cm、≥3cm 四组,以及选择其中直径在0.5cm-1.5cm 的 32 个结节,根据结节的位置深度分为深浅两组,分别比较弹性成像的诊断结果.结果 56 个甲状腺结节中,良性结节48 个,恶性结节8 个,其中良性结节弹性成像分级1 级28 个,2 级11 个,3 级7个,4 级2 个.恶性结节弹性成像分级：3 级1 个,4 级3 个,5 级4 个.另外,常规超声诊断良性41 个,恶性15 个,超声弹性成像诊断良性51 个,恶性5 个.其中常规超声诊断的灵敏性、特异性以及准确性分别为72.0%,81.0%,78.6%.超声弹性成像诊断的灵敏性、特异性以及准确性分别为86.7%,93.1%,92.6%.两组患者诊断差异显著（P〈0.05）,具有统计学意义.同时,四组不同大小的结节,结节越大,灵敏度就越低.两组不同深度的结节,位置越深,灵敏度越高.结论 在诊断甲状腺良恶性结节的时候,超声弹性成像有利于提高诊断的准确性,但是由于超声弹性成像受到多种因素的影响,具有-定的局限性.

Objective to study the value of ultrasound elastography in the diagnosis of benign and malignant thyroid nodules and influencing factors. Selectionmethods from April 2013 to May 2014, 40 cases with thyroid patients underwent, there are 56 thyroid nodules, for all of the patients taking ultrasound elasticity imaging andconventional ultrasonic characteristic check, all cases were confirmed by surgery pathology. Among them according to the size of the nodule is divided into 〈 1 cm, 1-2 cm, 2 --3 cm, 3 cm or more four groups, and choose 0.5 cm - 1.5 cm in diameter of 32 nodules, according to the location of the nodules depth is divided into two groups of depth,elasticity imaging diagnostic results were compared. Results 56, in thyroid nodule benign nodules 48, malignant nodules eight, including benign nodules elasticity imagingclassification 28 level 1, level 2, 11, 3 class seven, grade 4 2. Malignant nodules elasticity imaging classification： level 3 1, 3, 4 four level 5. In addition, conventional ultrasounddiagnosis of benign 41, malignant 15, ultrasound elastography in the diagnosis of benign 51, 5 malignant. The conventional ultrasonic diagnostic sensitivity, specificity andaccuracy were 72.0%, 81.0%, 78.6%. Ultrasound elasticity imaging diagnostic sensitivity, specificity and accuracy were 86.7%, 93.1%, 92.6%. Two groups of patients withdiagnosis of significant difference （P 〈 0.05）, with statistical significance. At the same time, four groups of different sizes of tubers, the greater the nodules, the lower thesensitivity. Two groups of different depth of nodes, the deeper the location, the higher the sensitivity. Conclusion in the diagnosis of benign and malignant thyroid nodules, toimprove the diagnostic accuracy of ultrasound elasticity imaging, but because of ultrasound elastography affected by many factors, has a certain limitation.