二维超声联合微血管成像技术在甲状腺微小结节良恶性诊断中的应用价值

The application value of 2D ultrasound combined with superb micro-vascular imaging(SMI) in the diagnosisof benign and malignant thyroid micronodule

目的探讨二维(2D)超声联合微血管成像技术(SMI)在甲状腺微小结节良恶性诊断中的应用价值。方法回顾性分析甲状腺结节手术115例患者共123个微小结节治疗资料。术前所有结节均进行2D及SMI检查,通过2D、SMI及2D联合SMI(并联/串联)4种方法分别得出微小结节的良恶性;与其术后病理结果对照,得出4种方法诊断甲状腺微小恶性结节的灵敏度、特异度、准确率、阳性预测值、阴性预测值。结果术后病理结果:共123个结节,良性21个、恶性102个;2D、SMI及二者联合(并联/串联)检查诊断甲状腺微小恶性结节的准确率为80.5%、88.6%、97.9%及79.7%;灵敏度为80.4%、91.2%、98.4%及77.5%;特异度80.9%、76.2%、61.9%及90.5%;阳性预测值为95.3%、94.9%、92.6%及97.5%;阴性预测值为45.9%、64%、86.7%及45.3%。SMI的灵敏度高于2D,差异有统计学意义(P<0.05);2D联合SMI(并联)的阴性预测值高于SMI,差异有统计学意义(P<0.05);2D联合SMI(串联)的特异度高于SMI,灵敏度低于SMI,差异均有统计学意义(P<0.05)。结论2D联合SMI可以更好地诊断甲状腺微小结节的良恶性,并对甲状腺结节的临床治疗有指导意义。

Objective To explore the value of two-dimensional ultrasound(2D)combined with Superb Micro-vascular Imaging(SMI)in the diagnosis of benign and malignant thyroid micronodule.Methods A retrospectively analysis was conducted on 123 micronodules from 115 patients who underwent thyroid nodule surgery.All nodules underwent 2D and SMI examinations before surgery,the benign and malignant of small nodules were determined by 2D,SMI and 2D combined SMI(parallel/series).Compared with postoperative pathological results,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 2D ultrasound,SMI and 2D combined SMI(parallel/series)in the diagnosis of malignant thyroid micronodules were obtained.Results There were 21benign nodules and 102 malignant nodules.The accuracy of SMI and 2D combined SMI(parallel/series)in the diagnosis of malignant thyroid micronodules was respectively 80.5%,88.6%,97.9%and 79.7%.The sensitivity was respectively 80.4%,91.2%,98.4%and 77.5%.The specificity was 80.9%,76.2%,61.9%and 90.5%.The positive predictive values were 95.3%,94.9%,92.6%and 97.5%.The negative predictive values were 45.9%,64%,86.7%and 45.3%.The diagnostic sensitivity of SMI was significantly higher than that of 2D(P<0.05).The negative predictive value of 2D combined with SMI(concatenation)was higher than SMI(P<0.05).The diagnostic specificity was signifificantly lower than SMI(P<0.05).Conclusion 2D ultrasound combined with SMI can better diagnose the benign and malignant thyroid micronodules,which is of great significance for the clinical treatment of thyroid nodules.