超声造影联合弹性成像诊断甲状腺结节的临床应用价值及肿瘤预测值评估的初步探讨

The value of Contrast-enhanced ultrasound joint elastography diagnostic clinical application of thyroid nodule and tumor forecast evaluation of preliminary discussion

目的:探讨超声造影联合弹性成像在甲状腺结节鉴别诊断中的应用价值及对肿瘤预测值的初步研究。方法:对50例经手术病理证实的甲状腺结节的超声造影及弹性成像的图像特点进行回顾性分析,评估该种方法诊断的敏感性、特异性和诊断准确性,并将各诊断方法的诊断标准进行分级评分,得出相应良恶性结节的肿瘤预测值。结果:50个结节中,良性结节共31个,恶性结节共19个,良性结节在注射造影剂后均早于或等同于甲状腺周围实质增强,达峰值时增强强度等于或高于周围实质,多数可见周围环状增强;恶性结节以低增强为主,多数可见不均质增强。弹性成像方面,恶性结节评分在3分以上,良性结节评分多在3分以下,超声造影联合弹性成像检查在敏感性、特异性、准确性分别为89.5%、87.1%、88.0%;甲状腺良恶性结节肿瘤预测值分别为4.26、8.52。结论:超声造影联合弹性成像对甲状腺结节良恶性的鉴别有重要的临床价值,肿瘤预测值概念的提出对规范该项检查有重要的临床意义。

Objective To evaluate the ultrasonic imaging joint elasticity imaging applied value in differential diagnosis of thyroid nodules and preliminary study of the tumor predictive value.Methods 50 cases of thyroid nodule, which was confirmed by surgical pathology of the images of ultrasound imaging and elasticity imaging features were retrospectively analyzed, the evaluation of this kind of method in the diagnosis of sensitivity, specificity and diagnostic accuracy, and the diagnosis method of diagnostic criteria for classifying evaluation, it is concluded that the predicted value of the corresponding benign and malignant nodules tumor.Results 50 nodules,31 benign nodules, malignant nodules, a total of 19, benign nodules after injection of contrast agents are substantial enhancement around earlier than or equal to the thyroid, reached the peak enhancement strength equal to or higher than the surrounding nature, most visible around the annular enhancement;Malignant nodules is given priority to with low enhancement, most visible heterogeneous enhancement.Elasticity imaging, malignant nodules score above 3 points, benign nodules score below 3 points more, contrast-enhanced ultrasound combined elastic imaging in sensitivity, specificity and accuracy of 89.5%,87.1%,88.0 % respectively;Benign and malignant thyroid nodules tumor forecast is 4.26 and 8.52, respectively.Conclusion Contrast-enhanced ultrasound joint elasticity imaging of benign and malignant thyroid nodule identification has important clinical value, put forward to regulate the examination of the concept of tumor predicted has important clinical significance.