超声弹性成像对桥本甲状腺炎合并结节的诊断价值

Ultrasound elastography in diagnosis of Hashimoto's thyroiditis complicated with thyroid nodules

目的探讨超声弹性成像和常规超声在桥本甲状腺合并结节中的诊断价值。方法选取2013年1月至2014年12月间青岛市第三人民医院收治的42例经术后病理证实为桥本甲状腺炎合并结节的患者,同时接受常规超声和超声弹性成像检查,对两种诊断方法结果进行观察记录。以手术后病例诊断结果为准,对超声弹性成像和常规超声的诊断结果进行分析比较。结果42例患者共有48个病灶,其中恶性结节32个,平均直径为(1.30±0.62)cm;良性结节16个,平均直径为(1.40±0.56)cm,良恶性结节直径比较,差异无统计学意义(P>0.05)。32个恶性结节中,常规超声诊断恶性19个,良性13个;超声弹性成像诊断恶性30个,良性2个。16个良性结节中,常规超声诊断恶性3个,良性13个;超声弹性成像诊断恶性2个,良性14个。常规超声敏感度为59.4%,特异性为81.3%,阳性预测值为86.4%,阴性预测值为50.0%,符合率为66.7%。超声弹性成像敏感度为93.8%,特异性为87.5%,阳性预测值为93.8%,阴性预测值为87.5%,符合率为91.7%。结论在桥本甲状腺炎合并结节性质的诊断中,超声弹性成像敏感度高,具有较高的诊断价值。

Objective To compare the diagnostic value of ultrasound elastography and conventional ultrasound in the diagnosis of Hashimoto＇s thyroiditis complicated with thyroid nodules. Methods The study enrolled 42 postoperative patients pathologically confirmed as Hashimoto＇s thyroiditis complicated with tuberous and simultaneously detected by conventional ultrasound and ultrasound elastography in The Third People＇s Hospital of Qingdao from January 2014 2013 to December. The results were observed and recorded in the two diagnostic methods. Tking postoperative diagnosis results as the standard,the diagnostic results were compared between ultrasound elastography and conventional ultrasound. Results Total of 48 lesions were found in 42 patients,of which 32 were malignant nodules,with an average diameter of 1. 30 ± 0. 62 cm. and 16 were benign nodules,with an average diameter of 1. 40 ± 0. 56 cm. There was no significant difference of diameter between malignant and benign nodules（ P 〉 0. 05）,among the 32 malignant nodules,19 malignant nodules and 13 benign nodules were detected by conventional ultrasound and 30 malignant and2 benign nodules were detected by ultrasonic elastography; among the 16 benign nodules,3 malignant and13 benign nodules were detected by conventional ultrasound,and 13 benign and 2 malignant and 14 benign nodules were detected by ultrasonic elastography,sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate for conventional ultrasound were 59. 4%,81. 3%,86. 4%,50. 0%and 66. 7% respectively and for ultrasound elastography were 93. 8%,87. 5%,93. 8%,87. 5% and91. 7% respectively. Conclusions The diagnostic value of ultrasound elastography was high in the diagnosis of Hashimoto＇s thyroiditis complicated with thyroid nodules.