实时超声弹性成像在甲状腺小结节占位性病灶诊断中的价值

Ciincai value of real -time ultrasound elastography in the diagnosis of thyroid nodules

目的探讨实时超声弹性成像在甲状腺小结节占位性病灶诊断中的临床价值，为甲状腺小结节占位性病变患者的临床诊断以及治疗提供参考。方法回顾性分析甲状腺小结节占位性病变患者62例的临床资料，将实时超声弹性成像诊断结果与病理诊断结果比较，分析实时超声弹性成像对甲状腺小结节占位性病变患者诊断的准确性、敏感性和特异性。结果弹性分级为0级患者，病理检查显示为滤泡性腺瘤囊性变；弹性分级为Ⅰ级患者，病理检查显示为滤泡增生结节；弹性分级为Ⅱ级患者，病理检查显示为滤泡性腺瘤；弹性分级为Ⅲ级患者，病理检查显示为乳头状腺癌；弹性分级为Ⅳ级患者，病理检查显示为乳头状腺癌。患者弹性图像分级结果显示，分级为0级的患者中，3例为增生性结节，5例为滤泡性腺瘤；分级为Ⅰ级的患者中，5例为增生性结节，8例为滤泡性腺瘤，1例为乳头状腺癌；分级为Ⅱ级的患者中，6例为增生性结节，14例为滤泡性腺瘤，2例为乳头状腺癌；分级为Ⅲ级的患者中，4例为滤泡性腺瘤，6例为乳头状腺癌；分级为Ⅳ级的患者中，3例为滤泡性腺瘤，7例为乳头状腺癌。将患者实时超声弹性成像诊断结果与病理学检查结果比较显示，采用实时超声弹性成像诊断的准确性为93．5％，两者差异无统计学意义（P〉0．05），其敏感性为100．O％，特异性为72．6％。结论实时超声弹性成像对于甲状腺小结节占位性病灶良恶性的诊断具有较高的准确性，值得在诊断治疗中广泛推广。

Objective To explore the clinical value of real - time ultrasound elastography in the diagnosis of thyroid nodules, and to provide reference for the clinical diagnosis and treatment of patients with thyroid nodular lesions. Methods The clinical data of 62 patients with thyroid nodule occupying lesions were retrospectively analyzed. The results of real ＂time ultrasound elastography imaging and pathological diagnosis were compared, and the accuracy,sensitivity and specificity of real - time ultrasound elasticity imaging in the diagnosis of thyroid nodular lesions were analyzed. Results The patients with elastic grade 0, pathological examination showed follicular adenoma cystic degeneration;The patients with Mastic grade Ⅰ , pathological examination showed follicular hyperplastic nodules; The patients with elastic grade Ⅱ, pathological examination showed follicular gland tumor;The patients with elastic grade m, pathological examination showed papillary adenocareinoma; The patients with elastic grade IV, pathological examination showed papillary adenocarcinoma. In patients with elastic grade 0,3 patients had proliferative nodules, and 5 cases were follicular adenomas. Among the patients with grade Ⅰ ,5 cases were proliferative nodules,8 cases were follicular adenoma, 1 case of papillary adenocarcinoma; of grade Ⅱ patients,6 cases of proliferative nodules, 14 cases of follicular adenoma,2 cases of papillary adenocarcinoma. Among the patients with grade Ⅲ ,4 cases were follicular adenomas,and 6 cases were papillary adenocarcinomas. Among the patients with grade Ⅳ, 3 cases were follicular adenomas,7 cases were papillary adenocarcinomas. The diagnostic accuracy of real -time ultrasound elastography Was 93.5% ,and the difference was not statistically significant（ P 〉 0.05 ）. The sensitivity and specificity of real - time ultrasound elastography were 100. 0% and 72.6%. Conclusion Real - time ultrasound elastography has high accuracy in the diagnosis of benign and malignant lesions of thyroid nodules, it is worthy of being widely promoted.