常规超声联合声辐射脉冲成像在甲状腺结节定性诊断中的应用

Applications of Conventional Ultrasound Combined with Acoustic Radiation Force Impulse to Diagnose Thyroid Nodules

【目的】探讨常规超声联合声辐射脉冲成像技术（ARFI）在甲状腺结节定性诊断中的应用价值。【方法】采用常规超声联合ARFI技术、对经手术病理确诊的甲状腺结节患者104例130个结节进行超声诊断。其中经手术病理确诊恶性结节42个，良性结节88个。比较良、恶性结节剪切波速度（SWV）值及常规超声、ARFI检查和联合检查的灵敏度、特异度及确诊率。【结果】甲状腺良性结节SWwV值（1．98±0．63）m／s，显著低于恶性结节（2．22±0．63）m／s，其差异有统计学意义（P〈0．05）。常规超声诊断甲状腺结节良恶性的灵敏度、特异性、正确率分别为73．8％（31／42）、80．6％（71／88）、78．5%（102／130）；ARFI诊断甲状腺结节良恶性的灵敏度、特异性、正确率分别为90．5％（38／42）、85．2％（75／88）、86．9％（113／130）；两者联合使用灵敏度、特异性、正确率分别为95．2％（40／42）、87．5％（77／88）、90．O％（117／130）。【结论】甲状腺良性结节SwV值显著低于恶性结节；常规超声联合ARFI技术对甲状腺良、恶性结节的鉴别诊断具有一定的临床价值。

[Objectivel To evaluate the application of conventional ultrasound combined with acoustic radi- ation force impulse imaging （ARFI） to measure shear wave velocity （SWV） in the diagnosis of benign and ma- lignant thyroid nodules.[MethodlConventional ultrasound and ARFI technology were used to observe 130 nod- ules in 104 patients with thyroid nodules. Nodule-specific features of conventional ultrasound and shear wave velocity （SWV） were compared between the malignant and benign groups.[ResultslThere were statistical differences between malignant and benign thyroid nodules in conventional ultrasound. The SWV value of be- nign nodules were（1.98±0.63）m/s, whereas the values for malignant nodules were（2.22 ±0.63）m/s, the differences measured were statistically significant （ P 〈 0.05）. The sensitivity, specificity, and accuracy of conventional ultrasound in diagnosing benign and malignant tumors were 73.8 %, 80.6 ？%, and 78.5%, respectively. These values for the ARFI method were 90.5%, 85.2%, and 86.9%, respectively. These values of the combined method were 95.2%, 87.5%, and 90.0%, respectively.[Conclusion] The SWV values of malignant thyroid nodules were significantly higher than those of benign nodules. Conventional ultrasound combined with ARFI significantly improved the accuracy of diagnosis of benign and malignant thyroid nodules, and has some degree of clinical applications.