多模态超声在鉴别诊断甲状腺结节中的应用观察

Application of multimodal ultrasound in differential diagnosis of thyroid nodules

目的研究多模态超声在鉴别诊断甲状腺结节中的应用效果。方法选择2018年2月—2019年11月本院收治的103例(146枚结节)甲状腺结节患者作为研究对象,均在本院进行多模态超声检查,以病理学检查结果为金标准,回顾性分析患者临床资料,探究多模态超色鉴别甲状腺良恶性结节的灵敏度、特异度和准确度,并评估多模态超声与常规超声对结节的血流分级以及图像质量。结果103例(146枚结节)患者均经术后病理学检查,结果显示良性结节患者56例(共计78枚结节),恶性结节患者47例(共计68枚结节),恶性结节常规超声征象表现为低回声、形态不规则、边界模糊、明显微钙化等,血管血流状况为混合型;CEUS征象表现为增强形态以弥漫性和向心性为主、增强不均匀、增强后边界模糊;SWE征象显示图像分型以多彩病带为主(P<0.05)。多模态超声检查的敏感度、特异性、准确率以及一致性均明显高于常规超声(P<0.05)。常规超声和多模态超声对甲状腺良性结节血流分级差异无统计学意义(P>0.05),对恶性结节血流分级差异有统计学意义(P<0.05)。多模态超声图像质量评分显著高于常规超声(P<0.05)。结论多模态超声鉴别诊断甲状腺结节良恶性程度图像质量好,具有较高的敏感度、特异度以及准确度,且恶性结节具有较为明显的超声征象。

Objective To study the application effect of multimodal ultrasound in differential diagnosis of thyroid nodules.Methods A total of 103 patients(146 nodules)with thyroid nodules who were diagnosed and treated in the hospital from February 2018 to November 2019 were enrolled as the research subjects.The multimodal ultrasound examination was performed in all the patients.Taking pathological examination results as golden standard,clinical data of patients were retrospectively analyzed.The sensitivity,specificity and accuracy of multimodal ultrasound in differential diagnosis of benign and malignant thyroid nodules was assessed.The blood flow classification and image quality of nodules displayed by multimodal ultrasound and conventional ultrasound were evaluated.Results All the 103 patients(146 nodules)underwent postoperative pathology examination.The results showed that there were 56 cases(78 nodules)with benign nodules and 47 cases(68 nodules)with malignant nodules.The routine ultrasound findings of malignant nodules including low echo,irregular morphology,blurred borders and significant micro-calcification.And the vascular blood flow was a mixture type.CEUS findings including enhancement morphology(mainly on diffuse and centripetal types),uneven enhancement and blurred borders after enhancement.SWE findings showed that the image types were mainly colorful disease belts(P<0.05).The sensitivity,specificity,accuracy and consistency of multimodal ultrasound examination were significantly higher than those of routine ultrasound examination(P<0.05).There were no statistically significant differences between conventional ultrasound and multimodal ultrasound in blood flow classification of benign thyroid nodules(P>0.05),but the differences in blood flow classification of malignant nodules were statistically significant(P<0.05).The image quality score of multimodal ultrasound was significantly higher than that of conventional ultrasound(P<0.05).Conclusions The image quality of multimodal ultrasound is good,and it has high sensitivity,specificity and accuracy in the differential diagnosis of benign and malignant thyroid nodules.There are significant ultrasound signs in malignant nodules.