常规超声联合超声造影诊断甲状腺微小乳头状癌的价值分析

Analysis of the value of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

目的探讨常规超声联合超声造影诊断对甲状腺微小乳头状癌的诊断价值。方法选取86例疑似甲状腺微小乳头状癌患者作为研究对象,均进行常规超声联合超声造影诊断及病理诊断,比较常规超声联合超声造影诊断和病理诊断的检出情况,以病理诊断为金标准,分析常规超声联合超声造影的诊断结果,并分析其影像学表现。结果86例疑似甲状腺微小乳头状癌患者经病理诊断检出35例,其余51例为良性结节,经常规超声联合超声造影诊断检出甲状腺微小乳头状癌33例,检出率为38.37%,与病理诊断的40.70%(35/86)比较差异无统计学意义(P>0.05)。常规超声联合超声造影诊断甲状腺微小乳头状癌的阳性预测值为96.97%(32/33),阴性预测值为94.34%(50/53),敏感度为91.43%(32/35),特异度为98.04%(50/51),准确度为95.35%(82/86),约登指数为0.8947。超声诊断甲状腺微小乳头状癌具有特征性的影像学表现。甲状腺微小乳头状癌患者的血流以3级血流为主,在结节中存在丰富的血流信号。甲状腺微小乳头状癌存在颈部淋巴结转移,经超声诊断出的33例患者中存在重大淋巴结9例,占27.27%,其中经手术确诊淋巴结转移8例(24.24%)。结论常规超声联合超声造影诊断甲状腺微小乳头状癌具有较高的诊断价值,可以为临床的治疗工作提供参考依据。

Objective To discuss the value of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma.Methods 86 patients with suspected papillarythyroid microcarcinoma were selected as study subjects,all of whom underwent conventional ultrasound combined with contrast-enhanced ultrasound diagnosis and pathological diagnosis,and the detection of conventional ultrasound combined with contrast-enhanced ultrasound diagnosis and pathological diagnosis were compared.The diagnostic results of conventional ultrasound combined with contrast-enhanced ultrasound was analyzed using pathological diagnosis as the gold standard,and the imaging findings was analyzed.Results Among 86 patients with suspected papillary thyroid microcarcinoma,35 cases were diagnosed by pathology,and the remaining 51 cases were benign nodules.33 cases of papillary thyroid microcarcinoma were detected by conventional ultrasound combined with contrast-enhanced ultrasound diagnosis,with a detection rate of 38.37%,which was not statistically significant compared with 40.70%(35/86)of pathological diagnosis(P>0.05).The positive predictive value of conventional ultrasound combined with contrast-enhanced ultrasound for the diagnosis of papillary thyroid microcarcinoma was 96.97%(32/33),the negative predictive value was 94.34%(50/53),the sensitivity was 91.43%(32/35),the specificity was 98.04%(50/51),the accuracy was 95.35%(82/86),and the Youdon index was 0.8947.Ultrasound diagnosis of papillary thyroid microcarcinoma has characteristic imaging findings.The blood flow in patients with papillary thyroid microcarcinoma was mainly grade 3 blood flow,and there was abundant blood flow signal in the nodules.There were cervical lymph node metastases in papillary thyroid microcarcinoma.Of the 33 patients diagnosed by ultrasound,9 patients had major lymph nodes,accounting for 27.27%.Among them,8 cases(24.24%)were diagnosed with lymph node metastasis by surgery.Conclusion The combined diagnosis of conventional ultrasound and contrast-enhanced ultrasound has high diagnostic value,which can provide reference for clinical treatment.