超声造影对桥本甲状腺炎背景下甲状腺良恶性结节的诊断效能

Diagnostic Efficacy of Ultrasound Contrast on Benign and Malignant Thyroid Nodules under Hashimoto's Thyroiditis

目的探讨常规超声(US)与超声造影(CEUS)对于桥本甲状腺炎(HT)背景下甲状腺良恶性结节的诊断价值。资料与方法回顾性分析161个经手术病理证实的HT背景下的甲状腺良恶性结节,同时计算和比较US与CEUS诊断HT背景下甲状腺良恶性结节的敏感度(Sen)、特异度(Spe)、阳性预测值(PV+)、阴性预测值(PV-)、阳性似然比(LR+)、阴性似然比(LR-)、ROC曲线下面积(AUC)及95%CI。结果 CEUS诊断HT背景下甲状腺良恶性结节的Sen、Spe、PV+、PV-、LR+、LR-、AUC及其95%CI分别为95.8%(90.0%~98.4%)、88.1%(73.6%~95.5%)、95.8%(92.3%~99.3%)、88.1%(78.3%~97.9%)、8.05(3.53~18.3)、0.05(0.02~0.11)、0.951(0.911~0.991)。US诊断HT背景下甲状腺良恶性结节的Sen、Spe、PV+、PV-、LR+、LR-、AUC及其95%CI分别为88.2%(80.7%~93.2%)、81.0%(65.4%~90.9%)、92.9%(88.2%~97.6%)、70.9%(58.0%~83.8%)、4.6(2.5~8.7)、0.15(0.09~0.24)、0.840(0.756~0.923),CEUS各指标均优于US,差异有统计学意义(P<0.05)。结论 CEUS较US可以提高HT背景下甲状腺良恶性结节诊断的准确性。

Purpose To evaluate value of ultrasound（US） and ultrasound contrast enhanced（CEUS） in diagnosing benign and malignant thyroid nodules coexisting with Hashimoto＇s thyroiditis（HT）. Materials and Methods One hundred and sixty one benign and malignant thyroid nodules coexisting with HT confirmed by surgical pathology were retrospectively analyzed. Meanwhile, the sensitivity（Sen）, specificity（Spe）, positive predictive value（PV＋）, negative predictive value（PV-）, positive likelihood ratio（LR＋）,negative likelihood ratio（LR-）, area under curve（AUC） of ROC and 95% CI of CEUS and US＇s in diagnosing benign and malignant thyroid nodules coexisting with HT were calculated and compared. Results The Sen, Spe, PV＋, PV-, LR＋, LR-, AUC and their95% CI of CEUS in diagnosing benign and malignant thyroid nodules coexisting with HT was 95.8%（90.0%-98.4%）, 88.1%（73.6%-95.5%）, 95.8%（92.3%-99.3%）, 88.1%（78.3%-97.9%）, 8.05（3.53-18.3）, 0.05（0.02-0.11）, 0.951（0.911-0.991） respectively. The Sen, Spe, PV＋, PV-, LR＋, LR-, AUC and their 95% CI of US in diagnosing benign and malignant thyroid nodules coexisting with HT was 88.2%（80.7%-93.2%）, 81.0%（65.4%-90.9%）, 92.9%（88.2%-97.6%）, 70.9%（58.0%-83.8%）, 4.6（2.5-8.7）, 0.15（0.09-0.24） and0.840（0.756-0.923） respectively. Each CEUS indicator were better than US＇s（P〈0.05）. Conclusion CEUS can improve diagnosis accuracy of benign and malignant thyroid nodules coexisting with HT than US.