超声弹性成像评分法在儿童甲状腺结节性质判定中的探讨

Evaluation of Thyroid Nodules in Children by Ultrasonic Elastography Scoring

目的探讨超声弹性成像5分评分法在儿童甲状腺结节性质判定中的准确性。方法对62例儿童甲状腺结节患者共93个结节进行超声弹性成像检查,以病理结果为标准,回顾性分析儿童甲状腺良恶性结节在超声弹性成像评分1~5分各分值点的分布特点。结果在儿童患者中,良性结节在超声弹性成像评分中主要分布在1分和2分;恶性结节在超声弹性成像评分中主要分布在4分和5分。在评分为1、2、4、5这4个分值时,甲状腺良恶性结节的分布对比,差异有统计学差异(P<0.05)。评分值为3时,更倾向于良性结节的判定。结论超声弹性成像在儿童甲状腺结节的良恶性鉴别中,是一种有效的技术手段,当评分值为3分时,更倾向良性结节,但由于良恶性结节弹性系数之间存在一定的重叠,故当分值为3分时,不能轻易判定为良性,需结合常规超声及其他实验室检查进行判断。

Objective To evaluate the accuracy of the 5 point scoring method of ultrasonic elastography in the determination of thyroid nodules in children. Methods 62 children with thyroid nodules had 93 nodules were examined by ultrasonic elastography, based on the pathological results,the distribution characteristics of the scores of 1 to 5 points and scores of ultrasound elastography scores in children with benign and malignant thyroid nodules were analyzed retrospectively. Results In children, benign nodules were mainly distributed over 1 and 2 points in the ultrasound elastography score; The malignant nodules were mainly distributed in 4 and 5 points in the ultrasonic elastography score. When the scores were 1, 2, 4, 5 and 4, there were significant differences in the distribution of benign and malignant nodules between the two groups （P〈0.05）. When the score was 3, it was more favorable for the judgement of benign nodules. Conclusion Ultrasound elastography is an effective technique in the differential diagnosis of benign and malignant thyroid nodules in children, when the score is 3, more benign nodules are preferred, However, there is a certain overlap between the elastic coefficients of benign and malignant nodules, therefore, when the score of 3 points, can＇t be easily identified as benign, and should be combined with conventional ultrasound and other laboratory tests to determine.