超声弹性应变率比值法鉴别诊断桥本氏甲状腺炎背景下结节良恶性的价值

Value of ultrasonic elastography strain rate ratio method in differential diagnosis of benign and malignant thyroid nodules under the background of Hashimoto's thyroiditis

目的探讨实时超声弹性应变率比值(SR)法在评价桥本氏甲状腺炎(HT)背景下结节良恶性中的应用价值。方法分析186例(231个病灶)经手术病理证实的HT背景下甲状腺结节的超声弹性图像,计算病灶与同侧甲状腺组织的SR,绘制ROC曲线获得SR诊断恶性结节的截断值,分析其诊断效能。结果 231个HT合并甲状腺结节中,60个恶性结节SR中位数为3.11(1.89,5.08),171个良性结节SR中位数为1.59(1.15,2.17),差异有统计学意义(P<0.001)。以SR为2.73为截断值,其诊断HT背景下恶性结节的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为60.00%、86.55%、79.65%、61.02%,86.05%。结论实时超声弹性SR法可为鉴别HT背景下结节的良恶性提供可靠依据,具有较好的临床应用价值。

Objective To explore the clinical value of real-time ultrasonic elastography strain rate ratio(SR)method in evaluating benign and malignant thyroid nodules under the background of Hashimoto’s thyroiditis(HT).Methods A total of 186 patients with Hashimoto’s thyroiditis(231 pathologicly confirmed nodules)were included in this study.The strain ratio of each nodule in the same lateral thyroid was calculated by elastography,ROC curve was drawn to obtain cutoff value of SR in diagnosis of malignant nodules.Results In 231 nodules,60 nodules were malignant,171 nodules were benign.The median SR of benign and malignant nodules were 3.11(1.89,5.08)and 1.59(1.15,2.17),respectively,the difference was statistically significant(P<0.001).Taken 2.73 as the cutoff value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differential diagnosis of malignant nodules under the background of Hashimoto’s thyroiditis were 60.00%,86.55%,79.65%and 61.02%,86.05%,respectively.Conclusion The SR of real time ultrasonic elastography is helpful for differential diagnosis between malignant and benign nodules under the background of Hashimoto’s thyroiditis,which is valuable to be applied in clinic.