超声弹性成像及量化分级联合促甲状腺激素测定在良、恶性甲状腺结节鉴别方面的应用价值

Applicability of ultrasound elastography and quantitative grading combined with thyroid stimulating hormone in the identification of benign and malignant thyroid nodules

目的探讨联合应用超声弹性成像技术、量化分级系统及促甲状腺激素测定鉴别甲状腺结节良、恶性的价值。方法选取河北哈励逊国际和平医院2016年1月—2018年1月期间收治的184例甲状腺结节患者,术前均进行促甲状腺激素测定、常规二维超声和弹性成像检查,并以手术病理结果证实其良、恶性,分别统计各组及联合诊断的结果(灵敏度、特异度、准确度以及阳性预测值、阴性预测值)。结果 184例甲状腺结节中,恶性结节63例,良性结节121例,恶性结节占比34.24%;联合应用超声弹性成像技术、量化分级系统及促甲状腺激素测定诊断的结果显示,灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于3种诊断方法独立诊断的结果,差异有统计学意义(P<0.05)。结论超声弹性成像及量化分级联合促甲状腺激素测定综合检查法能够显著性提高诊断甲状腺结节良、恶性准确度,值得临床推广。

Objective To explore the applicability of the combined use of ultrasound elastography,quantitative grading system and thyroid stimulating hormone to differentiate benign and malignant thyroid nodules.Methods A total of 184 patients with thyroid nodules who were admitted to a tertiary hospital between January 2016 and January 2018 were selected.Preoperative thyroid stimulating hormone tests,conventional two-dimensional ultrasound and elastography were performed,while benign and malignant nodules were confirmed by surgical pathological results.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of each group and the comprehensive diagnostic results were statistically calculated.Results Among the 184 cases of thyroid nodules,there were 63 cases of malignant nodules that accounted for 34.24%of the total,and 121 cases of benign nodules.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were higher when the three methods were combined than when any of the methods was used alone,and the difference was statistically significant(P<0.05).Conclusion Ultrasound elastography and quantitative classification combined with thyroid stimulating hormone test can significantly improve the accuracy of diagnosis of benign and malignant thyroid nodules,which is worthy of clinical promotion.