二维超声联合彩色多普勒超声在甲状腺结节定性诊断中的应用价值及特征分析

Application value and ultrasound index analysis of two-dimensional ultrasound combined with color Doppler ultrasound in qualitative diagnosis of thyroid nodules

目的:分析二维超声联合彩色多普勒超声(CDU)诊断甲状腺结节(TN)良恶性的价值。方法:选取2023年1月—2024年4月郓城县人民医院收治的180例TN患者为研究对象,均行二维超声及CDU检查,以病理检查为金标准,分析二维超声、CDU单一检查及两者联合检查诊断TN良恶性的价值以及良恶性TN二维超声与CDU影像学特征。结果:病理检查结果显示,180例TN患者确诊恶性76例。以病理检查为金标准,二维超声检出恶性TN 65例,CDU检出恶性TN 67例,两者联合检出恶性TN 75例;两者联合诊断TN良恶性的灵敏度为97.37%、准确率为98.33%、阴性预测值为98.10%,均高于两者单独诊断,差异有统计学意义(P<0.05);Kappa检验结果显示,二维超声联合CDU诊断TN良恶性与金标准诊断TN良恶性的一致性极好(Kappa值=0.966,P<0.001);恶性TN患者病灶不规则、边界不清晰、无/低回声、血流丰富、内部结构致密占比高于良性TN患者,差异有统计学意义(P<0.05);恶性TN患者RI、PSV高于良性TN患者、EDV低于良性TN患者,差异有统计学意义(P<0.05)。结论:二维超声联合CDU可有效诊断出TN的良恶性,有一定的诊断价值,值得临床借鉴。

Objective To evaluate the diagnostic value of two-dimensional ultrasound combined with color Doppler ultrasound(CDU)for thyroid nodules(TN).Methods A total of 180 TN patients admitted to Yuncheng County People's Hospital from January 2023 to April 2024 were selected as the study objects.All of them underwent 2D ultrasound and CDU examination.Using pathological examination as the gold standard,the value of 2D ultrasound,CDU single examination and combined examination in diagnosing benign and malignant TN as well as the imaging features of benign and malignant TN were analyzed.Results Among 180 patients with TN,76 cases were confirmed malignant by pathological examination.Malignant was detected in 65 cases by two-dimensional ultrasound,67 cases by CDU,and 75 cases by combination.The sensitivity,accuracy and negative predictive value of the combined diagnosis of TN were 97.37%,98.33%and 98.10%respectively(P<0.05).Kappa test showed that 2D ultrasound combined with CDU was in good agreement with the“gold standard”(Kappa value=0.966,P<0.001).The incidence of irregular lesions,unclear boundaries,no/low echo,rich blood flow and dense internal structure in malignant TN patients was higher than that in benign TN patients(P<0.05).RI and PSV in patients with malignant TN were higher than those with benign TN,and EDV was lower than those with benign TN(P<0.05).Conclusion The combination of twodimensional ultrasound and CDU can effectively diagnose the malignancy of TN,and has certain diagnostic value,which is worthy of clinical reference.