血流灌注参数结合高频超声在恶性及良性甲状腺结节诊断中的临床价值

Clinical value of blood perfusion parameters combined with high-frequency ultrasound in diagnosis of malignant and benign thyroid nodules

目的 分析甲状腺良恶性结节诊断中血流灌注参数联合高频超声的应用价值。方法 选取2020年2月—2023年2月商丘市第一人民医院收治的91例甲状腺结节患者,其病理学结果显示良性结节60例(82个结节)为良性组,恶性结节31例(43个结节)为恶性组。入组者均行高频超声检查联合血流灌注参数检测,对比良性组与恶性组的高频超声声像图特征、血流灌注参数,并以病理诊断结果为金标准,将高频超声、血流灌注参数单一检查、高频超声联合血流灌注参数检查结果与病理诊断结果进行比较,分析不同检查方法对甲状腺良恶性肿瘤的诊断效能。结果 恶性组峰值强度(Peak)水平较良性组更低,达峰时间(time to Peak, Tp)、平均通过时间(mean transit time, MTT)水平较良性组更高(P<0.05);恶性组实性、低回声、极低回声、腺体外侵犯、边缘钙化及星点状钙化占比高于良性组,囊性或海绵状、纵横比<1、无回声、光滑或模糊、无或大彗星尾占比及粗钙化占比低于良性组(P<0.05);联合检测对甲状腺结节良恶性的诊断准确性、敏感性及特异性分别为98.90%、96.77%、100.00%,高于高频超声、血流灌注参数单一检查。结论 甲状腺良恶性结节诊断中血流灌注参数联合高频超声具有较高应用价值,可为疾病诊治提供可靠依据。

Objective To analyse the application value of blood perfusion parameters combined with high-frequency ultrasound in the diagnosis of benign and malignant thyroid nodules.Methods Totally 91 patients with thyroid nodules admitted in the First Peoples Hospital of Shangqiu from February 2020 to February 2023 were selected,whose pathological results showed 60 benign nodules(82 nodules)in the benign group and 31 malignant nodules(43 nodules)in the malignant group.The enrolled patients underwent high-frequency ultrasonography combined with blood perfusion parameter detection to compare the high-frequency ultrasonographic features and blood perfusion parameters of the benign group with those of the malignant group,and the pathological diagnostic results were used as the gold standard,comparing the results of high-frequency ultrasonography,single examination of blood perfusion parameters,high-frequency ultrasonography combined with blood perfusion parameter examination with the pathological diagnostic results,and analysing the diagnostic efficacy of the different methods of examination for benign and malignant tumours of the thyroid gland.Results The Peak level of malignant group was lower than that of benign group,and the levels of time to Peak(Tp)and mean transit time(MTT)were higher than that of benign group(P<0.05);the percentage of solid,hypoechoic,very hypoechoic,extra-glandular invasion,marginal calcification and stellate calcification was higher than that of benign group in the malignant group,and the percentages of cystic or spongy,aspect ratio<l,echogenicity,smooth or fuzzy,no or large comet's tail,and gross calcification were lower than that of benign group(P<0.05);the diagnostic accuracy,sensitivity and specifici ty of the combined test for benign and malignant thyroid nodules were 98.90%,96.77%and 100.00%,respectively,which were higher than that of high-frequency ultrasonography and single examination of blood perfusion parameters.Conclusion Blood perfusion parameters combined with high-frequency ultrasound have high value in the diagnosis of benign and malignant thyroid nodules,which can provide a reliable basis for the diagnosis and treatment of the disease.