弹性成像与超声造影联合应用诊断甲状腺微小乳头状癌的价值

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

目的:探讨弹性成像(UE)与超声造影(CEUS)联合应用诊断甲状腺微小乳头状癌(PTMC)的价值。方法:对常规超声检测出确定性困难的73例80个甲状腺微小结节进行UE及CEUS检查,所有结节均经手术病理证实。结果:80个结节中UE5分法诊断正确率为92.5%(74/80),其中3例恶性结节误诊为良性结节,3例良性结节误诊为恶性。CEUS诊断正确率为85.0%(68/80),其中6例PTMC误诊为良性病变,6例良性结节误诊为PTMC;UE诊断甲状腺微小癌的敏感性94.0%,特异性90.0%,准确性92.5%;CEUS诊断甲状腺微小癌的敏感性88.0%,特异性80.0%,准确性85.0%。联合应用UE和CEUS诊断甲状腺微小癌的敏感性96.7%,特异性92.7%,准确性94.9%。结论:UE和CEUS对于诊断PTMC方面均有较高的诊断价值,二者联合应用大于任意单项检查的诊断效能。

Objective： To evaluate the value of elasticity imaging and contrast- enhanced ultrasonography（ CEUS） in the diagnosis of papillary thyroid microcarcinoma（ PTMC）. Methods： In total,73 patients exhibiting a total of 80 small thyroid nodules,which were difficult to diagnose using conventional ultrasonography,underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination. Results： The accuracy rate of the elasticity imaging,based on the 5- point diagnostic method,was 92. 5%（ 74 /80 nodules）,of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. The correct diagnostic rate of CEUS was 85%（ 68 /80 nodules）,of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. Easticity imaging in the diagnosis of TMC was determined to have sensitivity,specificity and accuracy rates of 94. 0%,90. 0% and 92. 5%,respectively. The corresponding rates for CEUS were 88. 0%,80. 0% and 8 5. 0 %. The combined use of CEUS and UE were 96. 7%,92. 7%,and 94. 9%. Conclusion： The use of CEUS and UE had higher diagnostic value to the PTMC. The combined use was greater than any single inspection diagnosis efficiency.