CAJ | 학술논문

目的探讨实时超声弹性成像对常规超声可疑恶性甲状腺结节的鉴别诊断价值.方法对51例甲状腺单发实性小结节患者首先行灰阶超声检查,观察结节大小、形态、边界、内部回声、有无钙化、晕环等;再采用彩色能量多普勒超声观察结节内有无彩色血流及其分布;然后在纵切面进行实时弹性成像,将弹性图分为Ⅰ～Ⅴ级.将超声诊断结果与病理结果进行对照.结果超声弹性成像结果:Ⅰ、Ⅱ级共6例患者,均为良性;Ⅲ级9例(6例良性,3例恶性);Ⅳ、Ⅴ级共36例(34例恶性,2例良性).以弹性分级Ⅳ～Ⅴ级为高度恶性预测指标,其灵敏度为91.89%,特异度85.71%,准确率90.20%,阳性预测值94.44%,阴性预测值80.00%,明显高于灰阶和彩色能量多普勒超声(χ2=16.252,P<0.001).结论实时超声弹性成像对常规超声发现可疑恶性的甲状腺单发实性小结节的鉴别诊断有很大的帮助.
목적 탐토실시초성탄성성상대상규초성가의악성갑상선결절적감별진단개치.방법 대51례갑상선단발실성소결절환자수선행회계초성검사,관찰결절대소、형태、변계、내부회성、유무개화、훈배등;재채용채색능량다보륵초성관찰결절내유무채색혈류급기분포;연후재종절면진행실시탄성성상,장탄성도분위Ⅰ～Ⅴ급.장초성진단결과여병리결과진행대조.결과 초성탄성성상결과:Ⅰ、Ⅱ급공6례환자,균위량성;Ⅲ급9례(6례량성,3례악성);Ⅳ、Ⅴ급공36례(34례악성,2례량성).이탄성분급Ⅳ～Ⅴ급위고도악성예측지표,기령민도위91.89%,특이도85.71%,준학솔90.20%,양성예측치94.44%,음성예측치80.00%,명현고우회계화채색능량다보륵초성(χ2=16.252,P<0.001).결론 실시초성탄성성상대상규초성발현가의악성적갑상선단발실성소결절적감별진단유흔대적방조.
Objective To assess the diagnostic value of ultrasonographic elastography for identifying suspected malignant thyroid nodules. Methods Fifty-one patients with small single solid thyroid nodule underwent two-dimensional and color power Doppler ultrasonography. The size, shape, boundary, internal echo and halo, calcification of thyroid nodule were observed with two-dimensional ultrasound. Then color Doppler ultrasonography was used to detect blood signal and distribution in the nodules. Longitudinal scanning of elastography was performed, and the findings on elastography were classified into Ⅰ-Ⅴ grades. The ultrasonographic results were compared with pathologic findings. Results Six patients were found with grade Ⅰ and Ⅱ benign lesions;9 with grade Ⅲ ( 6 benign and 3 malignant), 36 with Ⅳ and Ⅴ (2 benign and 34 malignant) lesions on ultrasonographic elastography. Taking the elasticity grade Ⅳ or Ⅴ as malignant standard, the diagnostic sensitivity was 91.89%, specificity was 85.71%, accuracy was 90.20%, while the positive and negative predictive value was 94.44% and 80.00%, respectively. Conclusion Real-time ultrasound elastography is a promising imaging technique that can assist in the differential diagnosis of malignant thyroid small single solid nodule.