高频超声联合剪切波弹性成像技术对桥本氏甲状腺炎并发甲状腺结节良恶性的鉴别诊断价值分析

Analysis of the diagnostic value of high-frequency ultrasound combined with shear wave elastography in differentiating the benign and malignant nature of thyroid nodules in Hashimoto's thyroiditis

目的:探究高频超声联合剪切波弹性成像(Shear-wave elastography,SWE)技术对桥本氏甲状腺炎(Hashimoto's thyroiditis,HT)并发甲状腺结节良恶性的鉴别诊断价值。方法:回顾性收集2021年9月至2023年7月期间本院收治的35例HT合并甲状腺恶性结节患者纳入A组;35例HT合并甲状腺良性结节患者纳入B组。所有患者均经手术或病理活检结果证实。统计分析两组高频超声征象及剪切波弹性成像声像图表现;比较两组高频超声参数及杨氏模量均值;通过比较不同检查方式的诊断结果,分析其诊断效能。结果:高频超声、剪切波弹性成像技术联合诊断的灵敏度为94.29%,高于单独诊断(71.43%、71.43%),漏诊率为5.71%,低于单独诊断(28.57%、28.57%)(P<0.05);A组杨氏模量均值明显高于B组(P<0.05);A组边界模糊、强化不均匀、有微小钙化、结节内血管丰富占比高于B组,形态规则占比低于B组(P<0.05)。结论:高频超声、SWE技术联合诊断可显著提高诊断灵敏度,降低漏诊率,有利于临床尽早诊断HT背景下的结节性质,对改善患者预后具有重要意义。

Objective:To explore the value of high-frequency ultrasound combined with Shear-wave elastography(SWE)in the differential diagnosis of benign and malignant thyroid nodules in Hashimoto's thyroiditis(HT).Methods:A retrospective collection was conducted from September 2021 to July 2023,involving 35 patients with HT and malignant thyroid nodules admitted to our hospital,who were included in Group A,and 35 patients with HT and benign thyroid nodules,who were included in Group B.All patients were confirmed by surgery or pathological biopsy results.Statistical analysis was conducted on the high-frequency ultrasound signs and shear wave elastography sonograms of the two groups;the mean values of high-frequency ultrasound parameters and Young's modulus were compared between the two groups;and the diagnostic efficacy was analyzed by comparing the diagnostic results of different examination methods.Results:The sensitivity of combined diagnosis of high-frequency ultrasound and shear wave elastography was 94.29%,which was higher than that of single diagnosis(71.43%,71.43%).The missed diagnosis rate was 5.71%,which was lower than that of single diagnosis(28.57%,28.57%)(P<0.05).The average Young's modulus in group A was significantly higher than that in group B(P<0.05).The proportion of border blurring,uneven enhancement,microcalcification,and abundant blood vessels in nodules in group A was higher than that in group B,while the proportion of regular morphology was lower than that in group B(P<0.05).Conclusion:The combined diagnosis of high-frequency ultrasound and SWE technology can significantly improve diagnostic sensitivity and reduce the rate of missed diagnosis,which is beneficial for early clinical diagnosis of the nature of nodules in the context of HT and is of great significance for improving patient prognosis.