超声应变弹性成像评分联合超微血流分级鉴别甲状腺结节良恶性的价值

The value of ultrasound strain elastography combined with super microvascular classification in differentiating benign and malignant thyroid nodules

目的探讨超声应变弹性成像评分法联合超微血流分级在甲状腺结节良恶性鉴别诊断中的价值。方法回顾分析69例在我院进行常规超声检查的甲状腺结节病例,均已行应变弹性成像(strain elastography,SE)及超微血流成像(super microvascular imaging,SMI)检查。对比分析SE、SMI、SE联合SMI三种方法灵敏度、特异度和准确度之间的差异。应用构建ROC曲线进行分析,评估SE联合SMI鉴别甲状腺结节良恶性的价值。结果 SE联合SMI与SE、SMI敏感度、特异度、准确度组间两两对比,差异有统计学意义(P <0.05)。SE联合SMI最佳截断值是5.5.ROC曲线下面积比较:SE联合SMI的AUC(0.890)大于SE、SMI的AUC(0.766、0.738)。SE、SMI分别与SE联合SMI的AUC比较(Z=1.727,P=0.041 8;Z=2.046,P=0.020 2)差异有统计学意义。结论超声应变弹性评分联合超微血流分级可以提高鉴别甲状腺结节良恶性的诊断效能,在临床工作中具有推广价值.

Objective To investigate the value of ultrasound strain elastography(SE)combined with su-per microvascular imaging(SMI)classification in differential diagnosis between benign and malignant thyroid nod-ules.MethodsRetrospective analysis was made of 69 cases of thyroid nodules examined by conventional ultra-sound in our hospital,all the lesions were examined with SE and SIM. The sensitivity,specificity and accuracy ofSE,SMI and SE combined with SMI were compared and analyzed. The receiver operating characteristic(ROC)curve was constructed and the best truncation value was calculated. To evaluate the diagnostic value of SE com-bined with SMI in differentiating benign and malignant thyroid nodules.ResultsThe combined diagnosis was com-pared with SE and SMI in sensitivity,specificity and accuracy,the differences were significant(P < 0.05). Thebest cutoff value for SE combined with SMI was 5.5. Area comparison under ROC curve:SE combined with SMI di-agnosis AUC(0.890),AUC greater than SE and SMI diagnosis(0.766,0.738). The results of SE combined withSMI were compared with SE and SMI AUC respectively(Z = 1.727,P = 0.041 8,Z = 2.046,P = 0.020 2),andthe differences were significant.ConclusionUltrasound strain elastography combined with super microvascularclassification can improve the diagnosis of benign and malignant thyroid nodules,it has the value of popularizationin clinical work.