超声成像在甲状腺结节良恶性鉴别中的应用价值

Significance of sonography in the identification of benign and malignant thyroid nodules

目的探讨常规超声、超声造影和剪切波弹性成像超声在甲状腺结节良恶性鉴别中的应用价值。方法选取2015年7月至2017年2月间新疆医科大学附属肿瘤医院收治的90例甲状腺结节患者,均采用常规超声、超声造影和剪切波弹性成像超声进行检测,以病理诊断结果为准,比较三种不同检验方法的诊断敏感性、特异性及准确性。结果常规超声的诊断敏感性、特异性及准确性分别为70.0%、74.3%和73.3%,超声造影的分别为66.7%、75.0%和73.2%,剪切波弹性成像超声的分别为90.0%、80.0%和82.2%。常规超声与超声造影比较,差异无统计学意义(P>0.05);剪切波弹性成像超声显著高于常规超声和超声造影,差异均有统计学意义(均P<0.05)。联合诊断结果显示,常规超声联合剪切波弹性成像超声诊断价值最高,诊断敏感性、特异性及准确性分别为100.0%、80.0%和83.3%。结论剪切波弹性成像超声较常规超声和超声造影,在甲状腺结节良恶性的术前鉴别诊断中,应用价值最高,具有较好的敏感性、特异性和准确性,值得临床推广。

Objective To explore the significance of conventional ultrasound,contrast-enhanced ultrasonography and shear wave elasticity imaging in the identification of benign and malignant thyroid nodules. Methods Ninety patients with thyroid nodules who were treated at Affiliated Tumor Hospital of Xinjiang Medical University were enrolled from July 2015 to February 2017. Patients underwent conventional ultrasound,contrast-enhanced ultrasonography and shear wave elasticity imaging sonography,respectively.The results of pathological diagnosis were considered as the gold standard. The sensitivity,specificity and accuracy of the three different testing methods were compared. Results The diagnostic sensitivity,specificity and accuracy was 70. 0%,74. 3% and 73. 3%,respectively for the conventional ultrasound group,66. 7%,75. 0% and 73. 2%,respectively for the contrast-enhanced ultrasonography group and 90. 0%,80. 0% and 82. 2%,respectively for the shear wave elasticity imaging sonography group. There was no significant difference between the conventional ultrasound and contrast-enhanced ultrasonography（ P〉0. 05）.The efficacy of shear wave elasticity imaging ultrasonography was significantly higher than that of the conventional（ P〈0. 05）. The diagnostic value of conventional ultrasound combined with shear wave elasticity imaging was the highest and the diagnostic sensitivity,specificity and accuracy were 100. 0%,80. 0% and83. 3%,respectively. Conclusion Ultrasonography of shear wave elasticity imaging is the most valuable in the diagnosis of benign and malignant thyroid nodules compared with conventional ultrasound and contrastenhanced ultrasound. It has good sensitivity,specificity and accuracy. It is worthy of clinical promotion and application.