联合应用二维超声、彩色多普勒血流成像、超声造影及超声弹性成像技术并参照TI-RADS标准对甲状腺结节诊断价值的研究

Research on diagnosis value of the combined application of DUS, CEUS, UE, CDFI and TI-RADS in thyroid nodule

目的:探讨联合应用二维超声(Two-dimensional Ultrasound,DUS)、彩色多普勒血流成像(Color Doppler Flow Imaging,CDFI)、超声造影(Contrast-enhanced Ultrasound,CEUS)及超声弹性成像(Ultrasonic Elastic Imaging,UE),参照甲状腺影像数字报告系统(Digital Thyroid Imaging Reporting System TI-RADS)标准对甲状腺结节良恶性鉴别的诊断价值。方法:回顾性分析自2014年5月至2018年5月在包头医学院第一附属医院接受甲状腺切除的甲状腺结节患者100例,共118个甲状腺结节超声图像特征,与病理学检查结果对照,应用χ2检验分别分析各项超声指标图像特征及联合应用后对甲状腺结节的良恶性检出率。结果:以DUS、CDFI参照TI-RADS分级诊断甲状腺结节良恶性的敏感性、特异性及诊断准确性分别为55.6 %、58.6 %、57.8 %;CEUS诊断甲状腺结节良恶性的敏感性、特异性及诊断准确性分别为 80.6 %、81.4 %、73.9 %;UE的敏感性、特异性及诊断准确性分别为68.8 %、70.1 %、74.7 %;联合超声的敏感性、特异性及诊断准确性分别为93.8%、93.0%、93.2%。联合超声诊断和病理结果无差异( P =0.666>0.05)。结论:联合应用DUS、CDFI、CEUS及超声弹性成像技术并参照TI-RADS分级标准可收集更多的诊断信息进行综合分析,是一种更为全面,准确的甲状腺结节良恶性鉴别诊断方法。

Objective:To explore the diagnostic value of combining Two-dimensional Ultrasound (DUS), Color Doppler Flow Imaging (CDFI), Contrast-enhanced Ultrasound (CEUS) and Ultrasonic Elastic Imaging (UE) in the differential diagnosis of benign and malignant thyroid nodules with reference to Digital Thyroid Imaging Reporting System (TI-RADS). Methods:100 patients with thyroid nodules who underwent thyroidectomy in the First Affiliated Hospital of Baotou Medical College from May 2014 to May 2018 were retrospectively analyzed, including118 thyroid nodule ultrasound image characteristics. Compared with the results of pathological examination,χ2test was used to analyze the image characteristics of various ultrasound indexes and the detection rate of benign and malignant thyroid nodules after combined application. Results:The sensitivity, specificity and diagnostic accuracy of DUS and CDFI in the diagnosis of benign and malignant thyroid nodules by referring to the TI-RADS were 55.6 %、58.6 % and 57.8 % respectively. The sensitivity, specificity and diagnostic accuracy of CEUS were 80.6 %、81.4 % and 73.9 % respectively. The same indexes of UE were 68.8 %、70.1 % and 74.7 % respectively. And those data of combined ultrasound were 93.8 %、93.0 % and 93.2 % respectively. There was no difference between combined ultrasound diagnosis and pathological results ( P =0.666>0.05). Conclusion:Combined application of DUS, CDFI, CEUS and ultrasound elastography with reference to TI-RADS grading standard can collect more diagnostic information for comprehensive analysis, which is a more comprehensive and accurate method for differential diagnosis of benign and malignant thyroid nodules.