超声弹性成像对甲状腺乳头状癌淋巴结转移的诊断价值

The Value of Ultrasonic Elastography in the Diagnosis of Lymph Node Metastasis of Thyroid Papillary Carcinoma

目的分析在甲状腺乳头状癌淋巴结转移的诊断中超声弹性成像技术的临床诊断价值。方法选取2018年4月-2020年4月齐齐哈尔市中医医院收治的甲状腺乳头状癌患者124例作为研究对象,分别进行常规超声以及超声弹性成像检测,并以最终手术病理诊断结果作为金标准,将其分为淋巴结转移组(n=37)和非转移组(n=87),比较其检查结果。结果①常规超声诊断的敏感性为54.05%、特异性为83.91%,准确性为75.00%,超声弹性成像诊断的敏感性为78.38%,特异性为90.80%,准确性为87.10%,二者联合诊断的敏感性为91.89%,特异性为97.70%,准确性为95.97%,超声弹性成像检查的诊断准确率明显高于常规超声诊断的准确率,二者联合应用的诊断准确率明显高于单独采取任何一种检查的诊断准确率(P<0.05)。②转移组患者的弹性应变率明显高于非转移组(P<0.05)。结论对于甲状腺乳头状癌淋巴结转移患者在临床诊断中采取超声弹性成像具有较高的诊断准确性,但是将常规超声与超声弹性成像联合应用能够更进一步提高诊断的准确性。

Objective To analyze the clinical value of ultrasound elastography in the diagnosis of lymph node metastasis of thyroid papillary carcinoma. Methods 124 patients with thyroid papillary carcinoma treated in our hospital from April 2018 to April 2020 were examined by conventional ultrasound and ultrasonic elastography respectively. According to the final results of operation and pathology as the gold standard, they were divided into two groups: lymph node metastasis group(n=37)and non-metastasis group(n=87). The results were compared. Results(1) The sensitivity, specificity and accuracy of conventional ultrasound diagnosis were 54.05%, 83.91% and 75.00%, respectively.The sensitivity, specificity and accuracy of ultrasonic elastography were 78.38%, 90.80% and 87.10%,respectively. The sensitivity, specificity and accuracy of combined diagnosis were 91.89%, 97.70%and 95.97%, respectively. The diagnostic accuracy of ultrasonic elastography was significantly higher than that of conventional ultrasound, and the diagnostic accuracy of the combination of ultrasound and elastography was significantly higher than that of any single examination(P<0.05).(2) The elastic strain rate in the metastasis group was significantly higher than that in the non-metastasis group(P<0.05). Conclusion Ultrasonic elastography has higher diagnostic accuracy in clinical diagnosis of thyroid papillary carcinoma with lymph node metastasis, but the combined application of conventional ultrasound and ultrasonic elastography can further improve the diagnostic accuracy.