甲状腺微小癌的常规超声与超声弹性成像技术的应用比较

Comparison of conventional ultrasound and ultrasound elasticity imaging in thyroid carcinoma

目的分析常规超声和超声弹性成像对甲状腺微小结节的图像特征,比较两种方法对甲状腺微小癌的诊断价值。方法选取2010年~2014年在本院行甲状腺结节切除术的患者100例(结节149枚),切除标本均经病理结果确诊。所有患者均行常规超声和超声弹性技术成像检查。采用半定量评分法观察比较两种方法对甲状腺微小结节的诊断结果。结果 149枚结节中,良性101枚,占67.8%,恶性结节48枚,占32.2%。100例患者中,单发38例,其中良性23例,恶性15例;多发62例,其中良性49例,恶性13例。常规超声的灵敏度、特异度、误诊率、漏诊率以及诊断符合率分别为72.9%、81.2%、18.8%、27.1%、78.5%;超声弹性成像的灵敏度、特异度、误诊率、漏诊率以及诊断符合率分别为89.6%、89.1%、10.9%、10.4%、89.9%。超声弹性成像诊断对甲状腺微小癌的灵敏度和诊断符合率显著高于常规超声诊断,而漏诊率显著低于常规超声,差异均具有统计学意义(P<0.05);而在诊断的特异度和误诊率方面,两种方法差异无统计学意义(P>0.05)。结论超声弹性成像技术可提高甲状腺微小癌诊断的灵敏度和诊断符合率,有助于减少临床漏诊的发生,可作为常规超声的有效补充。

Objective To analyze the imaging ,features of micro nodules of thyroid by conventional uhrasound and uhrasound elastography, and to compare the diagnostic value of the two methods for thyroid micrecarcinoma. Methods 100 cases （ 149 nod- I ules） of thyroid nodule resection in our hospital from 2010 to 2014 were selected. All the resected specimens were diagnosed by pathology. All patients underwent conventional ultrasound and ultrasound elastography imaging examination. Semi-quantitative scoring method was used to observe and compare the results of two methods in the diagnosis of thyroid nodules. Results Of the 149 nodules, 101 were benign, accounting for 67.8%, and 48 were malignant, accounting for 32.2%. Among the 100 cases, 38 cases were single, including 23 cases of benign and 15 cases of malignant; 62 cases were multiple nodules, including 49 cases of benign and 13 cases of malignant. The sensitivity, -specificity, misdiagnosis rate, missed diagnosis rate and diagnostic coincidence rate of conventional ultrasound were 72.9%, 81.2%, 18.8%, 27.1%, 78.5% respectively; and those of ultrasound elasticity imaging were 89.6%, 89.1%, 10.9%, 10.4% and 89.9%, respectively. The sensitivity and diagnostic accuracy of ultrasound elasticity imaging in diagnosis of thyroid microcarcinoma were significantly higher than those of conventional ultrasound, while, the rate of missed diagnosis was significantly lower than that of conventional ultrasound （ P 〈 0.05）. As to the specificity and misdi- agnosis, there was no significant difference between the two methods （ P 〉 0.05）. Conclusion Ultrasound elasticity imaging can improve the diagnostic sensitivity and diagnostic accuracy of thyroid microcarcinoma and help to reduce the occurrence of missed diagnosis. It can be used as an effective sapplement of conventional ultrasound.