高频彩超联合超声弹性成像技术鉴别诊断良恶性甲状腺结节的价值

Value of High Frequency Color Ultrasound Combined with Ultrasound Elastography Technology in Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的:探讨高频彩超联合超声弹性成像技术鉴别诊断良恶性甲状腺结节的价值。方法:回顾性选取2021年5月—2023年12月仁怀市人民医院收治的89例甲状腺结节患者。所有患者均行高频彩超、超声弹性成像技术检查。分析甲状腺结节诊断情况及其与金标准的一致性。比较不同方法对甲状腺结节诊断价值。比较良恶性甲状腺结节高频彩超影像学特征。结果:89例甲状腺结节患者经金标准确诊40例恶性,49例良性。高频彩超检出36例恶性,检出率为90.00%(36/40);超声弹性成像技术检出37例恶性,检出率为92.50%(37/40);联合检查检出39例恶性,检出率为97.50%(39/40)。Kappa检验显示,高频彩超、超声弹性成像技术、联合检查与金标准的Kappa值分别为0.725、0.703、0.977(P<0.001)。联合检查敏感度、准确度、阴性预测值均高于单一检查,差异有统计学意义(P<0.05)。恶性甲状腺结节边界不清晰、形态不规则、纵横比≥1、微钙化占比均高于良性甲状腺结节,差异有统计学意义(P<0.05)。结论:高频彩超与超声弹性成像技术在良恶性甲状腺结节鉴别诊断中具有一定价值,联合检查可提高诊断准确性,便于精准治疗工作的开展。

Objective:To explore the value of high frequency color ultrasound combined with ultrasound elastography technology in differential diagnosis of benign and malignant thyroid nodules.Method:A total of 89 patients with thyroid nodules admitted to Renhuai City People's Hospital from May 2021 to Decenber 2023 were retrospectively selected.All patients were examined by high frequency color ultrasound and ultrasound elastography technology.The diagnosis condition of thyroid nodules and its consistency with the gold standard were analyzed.The diagnostic value of thyroid nodules by different methods was compared.The imaging features of benign and malignant thyroid nodules were compared.Result:Of the 89 patients with thyroid nodules,40 patients were malignant and 49 patients were benign.Totally 36 cases of malignant were detected by high-frequency color ultrasound,the detection rate was 90.00%(36/40).Ultrasound elastography technology detected 37 cases of malignancy,the detection rate was 92.50%(37/40).The combined examination detected 39 cases of malignant,the detection rate was 97.50%(39/40).Kappa test showed that the Kappa values of high-frequency color ultrasound,ultrasonic elastography technology,combined examination and gold standard were 0.725,0.703 and 0.977 respectively(P<0.001).The sensitivity and accuracy,negative predictive value of combined test were higher than that of single test,and the difference was statistically significant(P<0.05).The proportions of boundary was not clear,the shape was irregular,the aspect ratio was≥1,and microcalcification of malignant thyroid nodules were higher than those of benign thyroid nodules,the differences were statistically significant(P<0.05).Conclusion:The high frequency color ultrasound and ultrasonic elastography technology are valuable in the differential diagnosis of benign and malignant thyroid nodules,combined examinations may improve the diagnostic accuracy,to facilitate the development of precise treatment work.