MSCT、MRI及超声弹性成像在甲状腺结节诊断中的应用比较

Application comparison of MSCT, MRI and ultrasound elastography in the diagnosis of thyroid nodules

目的 探讨分析并比较MSCT、MRI及超声弹性成像在甲状腺结节诊断中的应用效果。方法 选取在本院行手术治疗的64例甲状腺结节患者,术前行MSCT、MRI及超声弹性成像检查,术后与病理学结果进行比较,统计不同诊断结果的符合率。结果 MSCT诊断良性结节30例(66.67%),恶性结节16例(84.21%),MRI诊断良性结节37例(82.22%),恶性结节14例(73.68%),超声弹性成像诊断良性结节43例(95.56%),恶性结节17例(89.47%),MSCT和MRI良性结节诊断准确率比较差异无统计学意义(P> 0.05),超声弹性成像良性结节诊断准确率显著高于MSCT(P <0.05);三种检查方式恶性结节诊断准确率与误诊率比较差异无统计学意义(P> 0.05);超声弹性成像漏诊率显著低于MSCT和MRI(P <0.05)。MSCT诊断灵敏度为46.15%,特异性为89.47%,准确率为71.88%,MRI诊断灵敏度为70.37%,特异性为86.49%,准确率为79.69%,超声弹性成像诊断灵敏度为84.21%,特异性为97.78%,准确率为93.75%;超声弹性成像灵敏度显著高于MSCT,超声弹性成像诊断准确率显著高于MSCT与MRI(P <0.05)。结论 与MSCT、MRI比较,超声弹性成像在甲状腺结节诊断中具有较高的诊断准确率,可有效降低漏诊率,利于甲状腺结节的发现与鉴别,是一种有效的诊断方式。

Objective To analyze and compare the application effect of MSCT,MRI and ultrasound elastography in the diagnosis of thyroid nodules.Methods 64 patients with thyroid nodules who underwent surgical treatment in our hospital were selected.MSCT,MRI and ultrasound elastography were performed before operation,and compared with pathological results after the operation,the coincidence rates of different diagnosis results were statistically analyzed.Results MSCT diagnosis showed benign nodules in 30 cases(66.67%),malignant nodules in 16 cases(84.21%);MRI diagnosis showed benign nodules in 37 cases(82.22%),malignant nodules in 14 cases(73.68%);ultrasound elastography diagnosis showed benign nodules in 43 cases(95.56%),malignant nodules in 17 cases(89.47%).There was no significant difference in diagnostic accuracy in benign nodules between MSCT and MRI(P>0.05),the diagnostic accuracy in benign nodules of ultrasound elastography was significantly higher than that of MSCT(P<0.05);there was no significant difference in diagnostic accuracy and misdiagnosis rate between three types of malignant nodules(P>0.05);the missed diagnosis rate of ultrasound elastography was significantly lower than that of MSCT and MRI(P<0.05).The sensitivity,specificity and accuracy of MSCT were 46.15%,89.47%and 71.88%respectively,the sensitivity,specificity and accuracy of MRI were 70.37%,86.49%and 79.69%respectively,the sensitivity,specificity and accuracy of ultrasound elastography were 84.21%,97.78%and 93.75%respectively;the sensitivity of ultrasound elastography was significantly higher than that of MSCT,the accuracy of ultrasound elastography was significantly higher than that of MSCT and MRI(P<0.05).Conclusion Compared with MSCT and MRI,ultrasound elastography has a higher diagnostic accuracy in the diagnosis of thyroid nodules,effectively reduces the rate of missed diagnosis,and is beneficial to the discovery and identification of thyroid nodules,which is an effective method of diagnosis.