超声弹性应变率比值法和等级评分法对甲状腺结节良恶性的鉴别诊断价值

Value of Ultrasonic Elastic Strain Rate Ratio Method and Grading Score Method for the Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的 探讨超声弹性应变率比值法和等级评分法对甲状腺结节良恶性的鉴别诊断价值。方法 选择2014年6月至2015年6月商洛市中心医院诊治的甲状腺结节患者80例,以组织病理学结果为金标准,观察超声弹性5级评分及超声弹性应变率比值法对甲状腺结节良恶性的诊断情况,计算并比较两种方法对甲状腺结节诊断的灵敏度、特异度、阳性预测值、阴性预测值及准确度。结果5级评分共显示良性（0~Ⅱ级）病变58例,恶性（Ⅲ~Ⅳ级）病变22例。病理学结果为良性甲状腺结节弹性应变率比值（SR）显著低于病理学结果为恶性结节（0.95±0.26比2.68±0.78）,差异有统计学意义（P〈0.01）。以SR≥1.45为判断恶性肿瘤的标准,超声弹性应变率比值法共诊断良性甲状腺肿瘤58例,恶性甲状腺肿瘤22例。超声弹性应变率比值法对甲状腺肿瘤诊断灵敏度（90.9%比86.4%）、特异度（96.6%比94.8%）、阳性预测值（90.9%比86.4%）、阴性预测值（96.6%比94.8%）及准确度（95.0%比92.5%）均略高于5级评分。结论 在甲状腺结节良恶性的鉴别诊断中,超声弹性应变率比值法和等级评分法均具有较高的价值。

Objective To investigate the value of ultrasonic elastic strain rate ratio method and grading score method in the differential diagnosis of benign and malignant thyroid nodules. Methods From Jun. 2014 to Jun. 2015,80 cases of thyroid nodules in Shangluo Central Hospital were included in the study,with the histopathology as standard ,the diagnosis of benign and malignant thyroid nodules by using the ratio meth- od of ultrasonic elasticity 5 and ultrasonic elastic strain rate was observed, and the sensitivity, specificity ,pos- itive predictive rate, negative predictive rate, accuracy of the two methods of diagnosis of thyroid nodules were calculated and compared. Results The 5 grade scores showed there were 58 patients with benign （ grade 0-Ⅱ ） lesions and 22 with malignant lesions（ grade Ⅲ-Ⅳ ）. With the pathology results as the standard, the SR of benign thyroid nodules was 0. 95±0. 26, the SR of malignant nodules was 2.68 ± 0.78, the difference was statistically significant （ P 〈 0. 01 ）. With SR≥1.45 as the standard for malignant tumor, ultrasonic elas-tography strain ratio method diagnosed 58 cases of beriign thyroid tumor, and 22 cases of malignant thyroid tumor. The diagnostic sensitivity （90. 9% vs 86. 4% ） ,specificity （96.6% vs 94. 8% ） ,positive predictive value （ 90.9% vs 86.4% ）, negative predictive value （ 96. 6% vs 94. 8% ） and accuracy （ 95.0% vs 92. 5% ） of thyroid tumors by using the ratio method of ultrasonic elastic strain rate were slightly higher than the 5 grades score method. Conclusion In differential diagnosis of benign and malignant thyroid nodules, ultrasonic elastic strain rate ratio method and grade score method both have high value.