超声弹性成像联合血清TSH、TT3、TT4在甲状腺结节良恶性诊断的临床价值研究

目的:探讨超声弹性成像联合血清促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)在甲状腺结节良恶性诊断的临床价值。方法:选择2018年1月至2019年12月我院收治的甲状腺结节患者80例,根据病理检查结果分为良性结节组(48例),恶性结节组(32例),所有患者术前进行血清TSH、TT3、TT4及超声弹性成像检查,比较各组血清TSH、TT3、TT4水平及超声弹性成像评分,分析甲状腺结节患者血清TSH、TT3、TT4水平与超声弹性成像评分的相关性,超声弹性成像联合血清TSH、TT3、TT4在甲状腺恶性结节诊断的临床价值。结果:恶性结节组血清TSH、TT3、TT4水平显著高于良性结节组,超声弹性成像评分高分比例显著高于良性结节组(P<0.05),经Pearson相关分析显示,甲状腺结节患者血清TSH、TT3、TT4水平与超声弹性成像评分呈正相关(P<0.05)。以病理诊断为金标准,超声弹性成像联合血清TSH、TT3、TT4诊断甲状腺恶性结节的灵敏度为96.88%,特异度为93.75%,准确度为95.00%,灵敏度、特异度和准确度优于单独血清TSH、TT3、TT4检测和单独超声弹性成像检测。结论:超声弹性成像联合血清TSH、TT3、TT4对甲状腺结节良恶性的鉴别诊断具有较好的临床价值。

The Clinical value of Ultrasound Elastography Combined with Serum TSH, TT3 and TT4 in the Diagnosis of Benign and Malignant Thyroid Nodules

ABSTRACT Objective: To investigate the clinical value of ultrasound elastography combined with serum Thyrotropin (TSH), total triiodothyronine (TT3), total thyroxine (TT4) in the diagnosis of benign and malignant thyroid nodules. Methods: 80 patients with thyroid nodules who were admitted to our hospital from January 2018 to December 2019 were selected, they were divided into benign nodule group (48 cases) and malignant nodule group (32 cases) according to the results of pathological examination. All patients were examined with serum TSH, TT3, TT4 and ultrasonic elastic imaging before operation, serum TSH, TT3 and TT4 levels and ultrasonic elastography scores were compared in each group, the correlation between the levels of TSH, TT3 and TT4 in serum and the score of ultrasonic elastography in patients with thyroid nodules were analyzed, the clinical value of ultrasound elastography combined with serum TSH, TT3 and TT4 in the diagnosis of thyroid malignant nodules were analyzed. Results: The levels of TSH, TT3 and TT4 in the malignant nodule group were significantly higher than those in the benign nodule group, and the proportion of high scores in the ultrasonic elastography was significantly higher than that in the benign nodule group (P<0.05). The Pearson correlation analysis showed that the levels of TSH, TT3 and TT4 in the thyroid nodule group were positively correlated with the ultrasonic elastography score (P<0.05). Take pathological diagnosis as gold standard, the sensitivity, specificity and accuracy of ultrasound elastography combined with serum TSH, TT3 and TT4 in the diagnosis of thyroid malignant nodules were 96.88%, 93.75% and 95.00%, respectively. The sensitivity, specificity and accuracy were better than those of serum TSH, TT3 and TT4 alone and ultrasound elastography alone. Conclusion: Ultrasound elastography combined with serum TSH, TT3, TT4 has better clinical value in the differential diagnosis of thyroid nodules.