甲状腺微小乳头状癌诊断中超声造影和弹性成像的应用价值

The Value of Ultrasonography and Elastography in the Diagnosis of Micro Papillary Thyroid Cancer

目的研究超声造影和弹性成像对甲状腺微小乳头状癌的诊断效果。方法回顾分析2018年7月—2021年7月徐州医科大学附属医院收治的58例疑似甲状腺微小乳头状癌患者,术前均行超声造影(contrast-enhanced ultrasonography,CEUS)和弹性成像检查[声触诊组织成像技术(virtual touch tissue imaging,VTI)],以病理学为诊断“金标准”,分析诊断结果、诊断效能及超声影像表现。结果超声造影联合弹性成像确诊率(94.83%)高于单独超声造影(72.41%)、单独弹性成像(77.59%);超声造影联合弹性成像灵敏度(94.87%)、特异度(94.74%)、阳性预测值(97.37%)及阴性预测值(90.00%)高于超声造影(78.95%、60.00%、78.95%、60.00%)及弹性成像(83.78%、66.67%、81.58%、70.00%),差异有统计学意义(χ^(2)=10.645、4.262、6.746、6.243、4.773,P<0.05)转移组PI值高于非转移组,差异有统计学意义(P<0.05);非转移组、转移组RT、WIS、TTP、TPH、MTT比较,差异无统计学意义(P>0.05)。结论超声造影+弹性成像可提高甲状腺微小乳头状癌诊断效能,能尽早确诊疾病,值得推广。

Objective To study the diagnostic effect of ultrasonography and elastography on micro papillary thyroid cancer.Methods A total of 58 suspected patients with thyroid micropapillary carcinoma admitted to the Affiliated Hospital of Xuzhou Medical University from July 2018 to July 2021 were retrospectively analyzed.Contrast-enhanced ultrasonography(CEUS)and elastography[virtual touch tissue imaging(VTI)]were performed preoperatively,and pathology was taken as the"gold standard"for diagnosis.The diagnostic results,diagnostic efficacy and ultrasonographic manifestations were analyzed.Results The diagnosis rate of CEUS combined with elastography(94.83%)was higher than contrast sonography alone(72.41%)and elastography alone(77.59%);CEUS combined with elastography sensitivity(94.87%),specificity(94.74%),positive predictive value(97.37%)and negative prediction value(90.00%)were higher than ultrasound imaging(78.95%,60.00%,78.95%,60.00%)and elastography(83.78%,66.67%,81.58%,70.00%),the difference was statistically significant(χ^(2)=10.6454.262,6.746,6.243,4.773,P<0.05)The PI value of metastasis group was higher than that of non-metastasis group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in RT,WIS,TTP,TPH and MTT between the non-metastasis group and the metastasis group(P>0.05).Conclusion Ultrasonography+elastography can improve the diagnostic efficacy of thyroid micro papillary carcinoma,and it is worthy to be recommended for early diagnosis of the disease.