弹性成像联合超声造影诊断甲状腺结节良恶性的价值分析

Elastic imaging combined with contrast-enhanced ultrasound in diagnosis of benign and malignant thyroid nodules

目的探讨甲状腺结节良恶性诊断中采用弹性成像联合超声造影检查的价值。方法选取2015年8月至2018年12月在本院就诊的甲状腺结节患者112例,均行常规超声检查、超声造影及弹性成像检查,并以病理结果为标准,比较弹性成像、超声造影及联合检查的结果及价值。结果弹性成像联合超声造影诊断甲状腺结节良恶性的准确性91.07%,明显高于单独弹性成像73.21%和超声造影检查78.57%,差异有统计学意义(P<0.05);弹性成像联合超声造影诊断甲状腺结节良恶性的敏感性、特异性分别为90.00%、91.94%,均高于单独弹性成像72.00%、74.19%和超声造影检查的74.00%、82.26%,差异均有统计学意义(均P<0.05);弹性成像联合超声造影诊断的阳性预测值及阴性预测值均高于单独弹性成像,差异均有统计学意义(均P<0.05);弹性成像联合超声造影诊断的阳性预测值及阴性预测值与单独超声造影比较,差异均无统计学意义(均P>0.05)。结论弹性成像联合超声造影诊断可有效提高甲状腺结节良恶性的诊断价值,有效鉴别良恶性甲状腺结节,为治疗方案的制定提供依据。

Objective To investigate the value of elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules. Methods 112 patients with thyroid nodules who were treated at our hospital from August, 2015 to December, 2018 were examined by conventional ultrasound, contrastenhanced ultrasound and elastography. The results and value of elastography, contrast-enhanced ultrasound and combined examination were compared according to the pathological results. Results The accuracy of elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules (91.07%) was significantly higher than that of elastography (73.21%) and that of contrast-enhanced ultrasound alone (78.57%)(P< 0.05);the sensitivity, specificity of elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules were 90.00%, 91.94%;those of elastography 72.00%, 74.19%;and those of contrast-enhanced ultrasound 74.00%, 82.26%;with statistical differences (P < 0.05);there was no statistical difference in the negative predictive value of elastography combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules (P > 0.05). Conclusion Elastic imaging combined with contrast-enhanced ultrasound can effectively improve the diagnostic value of benign and malignant thyroid nodules, effectively differentiate benign and malignant thyroid nodules, and provide a basis for the formulation of treatment plan.