常规超声联合超声弹性成像对甲状腺微小癌的诊断价值

Diagnostic value of conventional ultrasound combined with elastography in thyroid microcarcinoma

目的探讨常规超声联合超声弹性成像对甲状腺微小癌的诊断价值。方法收集2014年1月～2016年1月在阳江市人民医院住院治疗的甲状腺结节患者32例，采用常规超声和超声弹性成像技术观察患者的甲状腺结节情况，以病理结果作为“金标准”，分析比较常规超声、超声弹性成像及二者联合检测在甲状腺良恶性病变诊断中的真阴性率、真阳性率、假阴性率、假阳性率。结果病理检查结果显示：检出的48个病灶中，良性病灶32个，甲状腺微小癌16个。其中，常规超声、超声弹性成像及二者联合诊断甲状腺良恶性病变的真阴性率分别为87．50％、93．75％、96．87％；真阳性率分别为75．00％、87．50％、93．75％；假阴性率分别为25．00％、12．50％、6．25％；假阳性率分别为12．50％、6．25％、3．12％。超声弹性成像的真阴性率、真阳性率、假阴性率与常规超声比较，差异均有统计学意义（x^2=4．56、9．74、9．64，均P〈0．05）；常规超声联合超声弹性成像的真阴性率、真阳性率、假阴性率、假阳性率与超声弹性成像（x^2=3．97、5．28、9．79、10．90，均P〈0．05）及常规超声（x^2=7．88、13．63、16．87、19．24，均P〈0．05）比较，差异均有统计学意义。结论与常规超声比较，超声弹性成像技术在甲状腺微小癌的诊断方面具有一定的优势，二者联合应用可以大大提高甲状腺微小癌诊断的准确性。

Objective To explore the diagnostic value of ultrasound combined with elastography in diagnosis of thyroid micmcarcinoma. Methods Thirty-two patients with thyroid nodule from January 2014 to January 2016 in the People＇s Hospital of Yangjiang City were selected, the thyroid nodules of the patients were observed by conventional ultrasound and ultrasound elastography. The pathological results was set as the ＂gold standard＂, the negative rate, true positive rate, false negative rate, false positive rate of conventional ultrasound and ultrasound elastography and joint detection in the diagnosis of benign and malignant thyroid lesions were analyzed and compared. Results Pathological examination showed that： 48 lesions were detected, including 32 benign lesions, 16 cases of thyroid cancer. The true negative rate of conventional ultrasound, ultrasound elastography and joint detection in the diagnosis of benign and malignant thyroid lesions was 87.50%, 93.75%, 96.87% respectively; the true positive rate was 75.00%, 87.50%, 93.75% respectively; the false negative rate was 25.00%, 12.50%, 6.25% respectively; the false positive rate was 12.50%, 6.25%, 3.12% respectively. The true negative rate （x^2 = 4.56, P 〈 0.05）, true positive rate （x^2 = 9.74, P 〈 0.05）, false negative rate （x^2= 9.64, P 〈 0.05）, false positive rate （x^2 = 9.76, P 〈 0.05） of conventional ultrasound and elastography had statistically significant differences; the differences in the true negative rate, true positive rate, false negative rate, false positive rate were statistically significant between joint detection and ultrasound elastography （x^2 = 3.97, 5.28, 9.79, 10.90, all P 〈 0.05）, as well as between conventional ultrasound and ultrasound elastography （x^2= 7.88, 13.63, 16.87, 19.24, all P 〈 0.05）. Conclusion Compared with conventional ultrasound, ultrasound elastography has certain advantages in the diagnosis of thyroid microcarcinoma, both combination can greatly improve the accuracy of thyroid micro-carcinoma diagnosis.