非侵入性超声多模态影像诊断甲状腺微小癌的价值

Value of non-invasive ultrasound multi-mode imaging in diagnosing of thyroid microcarcinoma

目的:探讨非侵入性超声多模态影像(二维灰阶超声、彩色多普勒超声及弹性成像)诊断甲状腺微小癌(thyroid microcarcinoma,TMC)的可行性及价值。方法:超声检查110例患者共120个甲状腺微小结节,使用非侵入性超声多模态影像与侵入性细针穿刺活检(fine needle aspiration biopsy,FNA)诊断甲状腺微小癌,并结合病理结果,对TMC非侵入性超声多模态特征与FNA结果进行对比。结果:120个甲状腺微小结节中,恶性62个,良性58个。从敏感性、特异性、阳性预测值和阴性预测值方面比较,多模态超声分别为91.94%、89.66%、90.16%、88.14%,而常规超声、彩色多普勒超声及弹性成像分别为79.03%、79.31%、80.33%、77.97%,69.35%、68.97%、70.49%、67.80%,72.58%、72.41%、73.77%、71.19%,差异有统计学意义(P<0.05)。FNA诊断甲状腺微小癌的敏感性、特异性、阳性预测值、阴性预测值分别为85.48%、86.21%、86.89%、84.75%。二者差异无统计学意义(P>0.05)。结论:非侵入性多模态超声在诊断TMC的效能方面与FNA诊断TMC效能相当。

Objective:To explore the feasibility and value of non-invasive ultrasound multi-mode imaging in diagnosing thyroid microcarcinoma(TMC).Methods:120 nodules of 110 patients with small thyroid nodules were examined by two-dimensional gray scale ultrasound,color Doppler ultrasound,elastic imaging and fine needle aspiration biopsy(FNA)to diagnose TMC,and the value of non-invasive ultrasound multi-modal images in the diagnosis of TMC were compared with FNA.Results:In 120 thyriod micro-nodules,there were 62 malignant nodules and 58 benign nodules.The sensitivity of non-invasive ultrasound multi-mode image diagnosis was 91.94%,the specificity was 89.66%,the prediction positive value was 90.16%,while the prediction negative value was 88.14%.The sensitivity of FNA was 85.48%,the specificity was 86.21%,the prediction positive value was 86.89%,while the prediction negative value was 84.75%.There was no significant difference in diagnostic value between two methods(P>0.05).Conclusion:The effectiveness of non-invasive multi-mode ultrasound in diagnosing TMC is equivalent to that of FNA.