超声造影和超声弹性成像在甲状腺良恶性结节鉴别诊断中的临床价值

目的:探讨超声造影与超声弹性成像鉴别诊断甲状腺良恶性结节的临床价值。方法:回顾性分析2011年1月-2013年6月我院经病理证实的128例甲状腺占位性病变患者(160个结节)的超声影像学资料,其中恶性结节68个,良性占位92个,评估实时超声造影与超声弹性成像诊断甲状腺良性与恶性结节的敏感性、特异性、准确率、阳性预测值及阴性预测值。结果:甲状腺良性结节超声造影检查以快进慢出、高增强为主;恶性结节以慢进快出、低增强为主。超声造影诊断甲状腺良、恶性结节的灵敏度、特异度与阳性预测值、阴性预测值及其诊断符合率分别为91.18%、92.39%、91.18%、93.41%、91.88%;超声弹性成像分别为89.71%、90.22%、87.14%、92.22%、90.00%,联合检查分别为94.12%、95.65%、94.12%、95.65%、95.00%,均高于常规超声的57.35%、72.83%、60.94%、69.79%、65.63%,比较差异有统计学意义(P0.05);联合检查灵敏度、符合率明显高于超声造影与超声弹性成像单一检查,比较差异有统计学意义(P0.05)。结论:超声造影与超声弹性成像在鉴别诊断甲状腺良恶性结节中均具有较高的应用价值,两种方法联合检查灵敏度及准确性更高。

Clinical Value of Contrast-Enhanced Ultrasound and Ultrasonic Elastography in Differential Diagnosis of Benign and Malignant Thyroid Nodules

Objective:To investigate the clinical value of contrast-enhanced ultrasound and ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules.Methods:Ultrasonic imaging data of 128 cases of thyroid lesions patients with 160 nodules that were pathologically confirmed from January 2011 to June 2013 in our hospita, were retrospectively analyzed ,68 nodules were malignant and 92 were benign. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of contrast-enhanced ultrasound and ultrasonic elastography were evaluated in the differential diagnosis of benign and malignant thyroid nodules.Results:Benign thyroid nodules contrast-enhanced ultrasound examination presented images of going in fast and out slow and high degree of enhancing ,while malignant nodules with presented going in slow and out fast and low degree of enhancing; In ultrasonic imaging examination for the diagnosis of benign and malignant thyroid nodules, specific degree of sensitivity, positive predictive value, negative predictive value and diagnostic coincidence rate were 91.18%, 92.39%, 91.18%, 93.41%, and 91.18% respectively; In ultrasound elasticity imaging examination, data were 89.71%, 90.22%, 87.14%, 92.22%, and 87.14%, Data for combined inspection were 94.12%, 95.65%, 94.12%, 95.65% and 94.12%, higher than those for conventional ultrasound (57.35%, 72.83%, 60.94%, 69.79% and 65.63%), the difference was statistically significant(P<0.05); The sensitivity, the coincidence rate of combined inspection were significantly higher than those of simple contrast-enhanced ultrasound or ultrasonic elastography (P<0.05).Conclusion:Contrast-enhanced ultrasound and ultrasound elastography has higher application value in the differential diagnosis of benign and malignant thyroid nodules, joint inspection of these two methods presents higher sensitivity and higher accuracy.