超声造影参数联合血清TSH对微小甲状腺结节性质的鉴别效能分析

Differential Efficacy of Contrast-enhanced Ultrasound Parameters Combined with Serum TSH in the Diagnosis of Micro Thyroid Nodules

目的 观察超声造影参数联合血清TSH对微小甲状腺结节性质的鉴别效能。方法 将2019年1月至2019年10月在我院进行住院治疗的94例微小甲状腺结节病例作为研究对象,所有病例均行超声甲状腺结节造影及血清TSH检测,获取超声造影参数(RT、MTT、TPH、WIS、TTP、PI、AUC)。全部患者在术中取病理组织并进行病理检查,并将检查结果作为“金标准”,同时对比超声造影联合血清TSH与病理检查结果的良恶性诊断符合率,同时进行超声造影参数联合血清TSH的结节良恶性诊断价值的ROC曲线分析。结果 手术后取病理组织显示,全部94例患者中,共有164个微小甲状腺结节中,其中良性结节有63例共108个结节,恶性结节中有31例共58个。良恶性微小甲状腺结节与血清TSH比较发现,比较差异无统计学意义。良、恶性微小甲状腺结节病例在RT、MTT、TPH、WIS、TTP上比较差异无差异性(P>0.05);恶性微小甲状腺结节病例的PI、AUC高于恶性微小甲状腺结节病例(P<0.05)。超声参数(PI、AUC)联合TSH鉴别诊断符合率(98.79%)高于超声参数PI联合TSH鉴别诊断(87.80%)、超声参数AUC联合TSH鉴别诊断(90.25%)(χ^(2)=13.129,P=0.001<0.05)。超声参数中Pl、AUC两项与血清TSH联合检测诊断的准确率、敏感性、特异性均相较于超声参数PI联合TSH较高(69.43%、72.48%、76.81%)、超声参数AUC联合TSH鉴别诊断(73.18%、85.63%、78.09%)(P<0.05)。结论 血清TSH有助于微小甲状腺结节鉴别,但超声造影参数(PI、AUC)联合血清TSH在微小甲状腺结节性质鉴别诊断中更具应用价值。

Objective To observe the differential efficacy of contrast-enhanced ultrasound parameters combined with serum TSH in identifying the nature of small thyroid nodules.Method:94 cases of small thyroid nodules hospitalized in our hospital from January 2019 to October 2019 were selected as the study subjects.All cases underwent contrast-enhanced ultrasound of thyroid nodules and serum TSH detection,and ultrasound contrast parameters(RT,MTT,TPH,WIS,TTP,PI,AU C)were obtained.All patients underwent pathological tissue extraction and examination during the surgery,and the examination results were used as the gold standard.At the same time,the diagnostic accuracy of benign and malignant nodules was compared between contrast-enhanced ultrasound combined with serum TSH and pathological examination results.At the same time,the ROC curve analysis of the diagnostic value of nodules with contrast-enhanced ultrasound parameters combined with serum TSH was performed.After surgery,pathological tissue samples were taken from all 94 patients,showing a total of 164 small thyroid nodules.Among them,there were 63 benign nodules with 108 nodules,and 31 malignant nodules with 58 nodules.The comparison between benign and malignant small thyroid nodules and serum TSH showed no statistically significant difference.There was no significant difference in RT,MTT,TPH,WIS,and TTP between benign and malignant cases of small thyroid nodules(P>0.05);The PI and AU C of malignant microthyroid nodules were higher than those of malignant microthyroid nodules(P<0.05).The coincidence rate of ultrasound parameters(PI,AU C)combined with TSH differential diagnosis(98.79%)was higher than that of ultrasound parameters PI combined with TSH differential diagnosis(87.80%)and ultrasound parameters AU C combined with TSH differential diagnosis(90.25%)(χ^(2)=13.129,P=0.001<0.05).The accuracy,sensitivity,and specificity of the combined detection of PI and AU C in ultrasound parameters and serum TSH were higher than those of PI combined with TSH(69.43%,72.48%,76.81%),and the differential diagnosis of AU C combined with TSH(73.18%,85.63%,78.09%)(P<0.05).Conclusion:Serum TSH is helpful in distinguishing small thyroid nodules,but the combination of contrast-enhanced ultrasound parameters(PI,AU C)and serum TSH has more practical value in distinguishing the nature of small thyroid nodules.