超声造影联合弹性成像对甲状腺微小结节的诊断价值

Diagnostic value of contrast-enhanced ultrasound combined with elastic imaging in the diagnosis of thyroid nodules

目的探讨超声造影联合弹性成像鉴别诊断甲状腺微小结节的应用价值。方法回顾性分析经手术病理证实的49例共69个甲状腺微小结节的超声造影和弹性成像表现,比较二者单独诊断及联合应用鉴别甲状腺微小结节良恶性的敏感性、特异性及诊断准确率。结果超声造影诊断甲状腺微小结节的敏感性为82.1%,特异性为87.8%,诊断准确率为85.5%;弹性成像诊断甲状腺微小结节的敏感性为85.7%,特异性为85.4%,诊断准确率为85.5%;二者联合诊断甲状腺微小结节的敏感性为92.8%,特异性为95.1%,诊断准确率为94.2%。单独超声造影或弹性成像诊断甲状腺微小结节的准确率比较差异无统计学意义;二者联合与单独超声造影或弹性成像检查诊断甲状腺微小结节的准确率比较,差异均有统计学意义(均P<0.05)。结论超声造影和弹性成像鉴别诊断甲状腺微小结节均有较高的诊断价值,二者联合有助于提高诊断准确率。

Objective To explore the application value of contrast-enhanced ultrasound combined with elastic imaging in differential diagnosis of thyroid nodules. Methods Retrospective analysis of 49 patients with surgically and pathologically proved a total of 69 thyroid small nodules of ultrasonic angiography and elastic imaging, the sensitivity, specificity and diagnostic accuracy of contrast-enhanced ultrasound,elastic imaging and combination in differential diagnosis of benign and malignant thyroid small nodules were compared. Results The sensitivity,specificity and diagnostic accuracy of contrast-enhanced ultrasonography in diagnosis of small thyroid nodules were 82.1%, 87.8% and 85.5%,those of elastic imaging and combination were 85.7%, 85.4%, 85.5% and 92.8%, 95.1%,94.2%,respectively. There was no significant difference of diagnostic accuracy between contrast-enhance ultrasonography and elastic imaging, while there was significant difference between the combination of both techniques and either one of them（all P〈0.05）. Conclusion Contrast- enhanced ultrasound and elastic imaging in differential diagnosis of thyroid nodules has a high diagnostic value, the combination is helpful to improve the accuracy of differential diagnosis of thyroid nodules.