超声造影参数与应变率比值鉴别诊断甲状腺良恶性结节的价值

Value of contrast-enhanced ultrasound parameters and strain rate ratio in the differential diagnosis of benign and malignant thyroid nodules

目的探讨超声造影参数与应变率比值对甲状腺良恶性结节的鉴别诊断价值。方法选取136例经病理证实的甲状腺结节患者(良性102例,恶性34例),均行二维超声、超声造影及弹性成像检查,获得超声造影时间-强度曲线下面积(AUC)、峰值强度(Peak)、达峰时间(Tp)、造影剂平均通过时间(MTT)及应变率比值,比较良恶性结节上述各参数的差异。以病理结果为金标准,分析超声造影和弹性成像对甲状腺良恶性结节的诊断效能。结果甲状腺恶性结节的AUC、Peak均低于良性结节,而Tp、应变率比值均高于良性结节,差异均有统计学意义(均P<0.05);甲状腺恶性结节的MTT与良性结节比较差异无统计学意义。超声造影诊断甲状腺恶性结节的敏感性、特异性、准确率均高于弹性成像(85.29%vs.73.52%、93.14%vs.86.27%、91.18%vs.83.09%),差异有统计学意义(均P<0.05)。结论超声造影参数较应变率比值在甲状腺良恶性结节鉴别诊断中的价值更高,可为临床治疗提供参考依据。

Objective To investigate the value of contrast-enhanced ultrasound parameters and elastography strain rate ratio in the differential diagnosis of benign and malignant thyroid nodules.Methods The clinical data of 136 patients with thyroid nodules were selected.A total of 102 cases of benign nodules and 34 cases of malignant nodules were confirmed by pathological examination.Two-dimensional ultrasound,contrast-enhanced ultrasound and elastography detection were performed to obtain area under curve(AUC),peak intensity(Peak),time to peak(Tp),average transit time of contrast agent(MTT)and strain rate.The differences of above parameters in benign and malignant nodules were compared.Taking pathological results as golden standard,the diagnostic efficacy of contrast-enhanced ultrasound and elastography for benign and malignant thyroid nodules were analyzed.Results The AUC and Peak of malignant thyroid nodules are lower than that of benign nodules,while the ratio of Tp and elastography strain rate was higher than that of benign nodules(all P<0.05),the MTT of malignant thyroid nodules was the same as that of benign nodules,with statistical significance.There was no significant difference in MTT between malignant thyroid nodules and benign thyroid nodules.The sensitivity,specificity and accuracy of contrast-enhanced ultrasound were higher than those of elastography(85.29%vs.73.52%,93.14%vs.86.27%,91.18%vs.83.09%).The differences were statistically significant(all P<0.05)Conclusion Compared with strain rate ratio,contrastenhanced parameters has higher value in the differential diagnosis of benign and malignant thyroid nodules,whick can provide reference for clinical treatment.