新医学
新醫學
신의학
NEW CHINESE MEDICINE
2014年
3期
173-177
,共5页
超声造影%弹性成像%甲状腺结节
超聲造影%彈性成像%甲狀腺結節
초성조영%탄성성상%갑상선결절
Contrast-enhanced ultrasound%Elastography%Thyroid nodules
目的：评价超声造影联合超声实时组织弹性成像（RTE ）在甲状腺良恶性结节诊断中的应用价值。方法分析85例甲状腺结节患者的超声造影和RTE的图像信息并与病理活组织检查（活检）相对比，评估单用两种方法及联合使用两种方法诊断的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率。结果85个甲状腺结节中，病理活检证实恶性病灶48个，良性病灶37个。恶性结节在注射造影剂后以不均匀低增强为主，早于周边甲状腺组织消退。良性结节则以弥散性等增强或高增强为主，晚于周围腺体廓清。超声造影的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为91.67％、81.08％、91.67％、81.08％、87.06％；RTE 则分别为87.50％、83.78％、87.50％、83.78％、85.89％；两者联合诊断的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为97.92％、86.49％、90.38％、96.97％、92.94％。超声造影联合 RTE 灵敏度、特异度、阴性预测值及诊断符合率比单用超声造影或RTE高（均P＜0.05）。结论超声造影联合RTE可提高甲状腺良恶性结节诊断的准确性。
目的：評價超聲造影聯閤超聲實時組織彈性成像（RTE ）在甲狀腺良噁性結節診斷中的應用價值。方法分析85例甲狀腺結節患者的超聲造影和RTE的圖像信息併與病理活組織檢查（活檢）相對比，評估單用兩種方法及聯閤使用兩種方法診斷的靈敏度、特異度、暘性預測值、陰性預測值及診斷符閤率。結果85箇甲狀腺結節中，病理活檢證實噁性病竈48箇，良性病竈37箇。噁性結節在註射造影劑後以不均勻低增彊為主，早于週邊甲狀腺組織消退。良性結節則以瀰散性等增彊或高增彊為主，晚于週圍腺體廓清。超聲造影的靈敏度、特異度、暘性預測值、陰性預測值及診斷符閤率分彆為91.67％、81.08％、91.67％、81.08％、87.06％；RTE 則分彆為87.50％、83.78％、87.50％、83.78％、85.89％；兩者聯閤診斷的靈敏度、特異度、暘性預測值、陰性預測值及診斷符閤率分彆為97.92％、86.49％、90.38％、96.97％、92.94％。超聲造影聯閤 RTE 靈敏度、特異度、陰性預測值及診斷符閤率比單用超聲造影或RTE高（均P＜0.05）。結論超聲造影聯閤RTE可提高甲狀腺良噁性結節診斷的準確性。
목적：평개초성조영연합초성실시조직탄성성상（RTE ）재갑상선량악성결절진단중적응용개치。방법분석85례갑상선결절환자적초성조영화RTE적도상신식병여병리활조직검사（활검）상대비，평고단용량충방법급연합사용량충방법진단적령민도、특이도、양성예측치、음성예측치급진단부합솔。결과85개갑상선결절중，병리활검증실악성병조48개，량성병조37개。악성결절재주사조영제후이불균균저증강위주，조우주변갑상선조직소퇴。량성결절칙이미산성등증강혹고증강위주，만우주위선체곽청。초성조영적령민도、특이도、양성예측치、음성예측치급진단부합솔분별위91.67％、81.08％、91.67％、81.08％、87.06％；RTE 칙분별위87.50％、83.78％、87.50％、83.78％、85.89％；량자연합진단적령민도、특이도、양성예측치、음성예측치급진단부합솔분별위97.92％、86.49％、90.38％、96.97％、92.94％。초성조영연합 RTE 령민도、특이도、음성예측치급진단부합솔비단용초성조영혹RTE고（균P＜0.05）。결론초성조영연합RTE가제고갑상선량악성결절진단적준학성。
Objective To evaluate contrast-enhanced ultrasound (CEUS)combined with real-time ultrasound elastography (RTE )in diagnosing benign and malignant thyroid nodules. Methods Eighty-five thyroid nodules were evaluated by CEUS and RTE. Two methods were compared with biopsy,the sensitivity, specificity,positive predictive value,negative predictive value and diagnostic coincidence rate were calculated.Results All these thyroid nodules included 48 malignant lesions and 37 benign lesions which were confirmed by biopsy. Malignant nodules were tend to show heterogeneous low-enhancement after the injection of contrast agent,receded earlier than the surrounding thyroid tissue. Majority of the benign nodules exhibited diffuse isoenhancement or hyperenhancement,cleared later than the surrounding glands. The sensitivity,specific de-gree,positive predictive value, negative predictive value and diagnostic coincidence rate of CEUS were 91.67%,81.08%, 91.67%, 81.08% and 87.06%;and those of RTE were 87.50%, 83.78%, 87.50%,83.78% and 85.89%;and those of CEUS combined with RTE were 97.92%, 86.49%, 90.38%,96.97% and 92.94%. The sensitivity,specific degree,negative predictive value and diagnostic coincidence rate of CEUS combined with RTE were higher than those of CEUS or RTE (P<0.05 ). Conclu-sions Contrast-enhanced ultrasound combined with elasticity imaging technology can improve the diagnosis of benign and malignant thyroid nodules.
