CAJ | 학술논문

目的：探讨超声弹性成像与超声造影技术在甲状腺微小癌（TMC）诊断中的应用价值。方法选择2013年1月至2014年4月佛山市第二人民医院以甲状腺占位病变收住入院的患者，利用常规二维超声筛查出直径≤10 mm的162个甲状腺实性结节，分别利用超声弹性成像和超声造影技术进行检查，以病理检查结果为金标准，对照超声弹性成像与超声造影技术对TMC诊断的敏感度和特异度。结果病理检查结果：良性结节118个，恶性结节44个。超声弹性成像、超声造影、弹性成像联合超声造影技术诊断TMC的敏感度、特异度、准确率、阳性预测值、阴性预测值均明显高于常规二维超声〔敏感度：88.64%（39/44）、90.91%（40/44）、95.45%（42/44）比81.82%（36/44），特异度：91.53%（108/118）、92.37%（109/118）、95.76%（113/118）比85.59%（101/118），准确率：90.74%（147/162）、91.97%（149/162）、93.26%（151/162）比84.56（137/162），阳性预测值：79.59%（39/49）、81.63%（40/49）、83.67%（41/49）比67.92%（36/53），阴性预测值：95.58（108/113）、96.46%（109/113）、97.35%（110/113）比92.66%（101/109），均P＜0.05〕。结论在对TMC的诊断上，超声造影和超声弹性成像技术均具有较高的诊断价值，两者联合使用效果最佳。
목적：탐토초성탄성성상여초성조영기술재갑상선미소암（TMC）진단중적응용개치。방법선택2013년1월지2014년4월불산시제이인민의원이갑상선점위병변수주입원적환자，이용상규이유초성사사출직경≤10 mm적162개갑상선실성결절，분별이용초성탄성성상화초성조영기술진행검사，이병리검사결과위금표준，대조초성탄성성상여초성조영기술대TMC진단적민감도화특이도。결과병리검사결과：량성결절118개，악성결절44개。초성탄성성상、초성조영、탄성성상연합초성조영기술진단TMC적민감도、특이도、준학솔、양성예측치、음성예측치균명현고우상규이유초성〔민감도：88.64%（39/44）、90.91%（40/44）、95.45%（42/44）비81.82%（36/44），특이도：91.53%（108/118）、92.37%（109/118）、95.76%（113/118）비85.59%（101/118），준학솔：90.74%（147/162）、91.97%（149/162）、93.26%（151/162）비84.56（137/162），양성예측치：79.59%（39/49）、81.63%（40/49）、83.67%（41/49）비67.92%（36/53），음성예측치：95.58（108/113）、96.46%（109/113）、97.35%（110/113）비92.66%（101/109），균P＜0.05〕。결론재대TMC적진단상，초성조영화초성탄성성상기술균구유교고적진단개치，량자연합사용효과최가。
Objective To evaluate the value of the application of ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma(TMC). Methods The in-patients with thyroid lesions admitted in the Second People's Hospital of Foshan City from January 2013 to April 2014 were enrolled. Two-dimensional ultrasonography was used to screen the 162 solid thyroid nodules with a diameter ≤10 mm;they were examined by ultrasonic elastography and ultrasound contrast imaging respectively,and the result of pathological examination was regarded as the golden standard to compare the sensitivity and specificity between ultrasonic elastography and ultrasound contrast imaging for the diagnosis of TMC. Results The pathological results showed there were benign nodules 118 and malignant nodules 44 in number. The sensitivity,specificity,incidence of accuracy,positive predictive value and negative predictive value of the diagnosis of TMC by ultrasonic elasticity imaging,ultrasound imaging,and elasticity imaging combined with ultrasound imaging were much higher than those by two-dimensional ultrasonography〔sensitivity:88.64%(39/44),90.91%(40/44),95.45%(42/44)vs. 81.82%(36/44);specificity:91.53%(108/118),92.37%(109/118),95.76%(113/118)vs. 85.59%(101/118);accuracy:90.74%(147/162), 91.97%(149/162),93.26%(151/162)vs. 84.56(137/162);positive predictive value:79.59%(39/49),81.63%(40/49),83.67%(41/49)vs. 67.92%(36/53);negative predictive value:95.58%(108/113),96.46%(109/113), 97.35%(110/113)vs. 92.66%(101/109),all P<0.05〕. Conclusion For the diagnosis of TMC,both ultrasonic elastography and ultrasound contrast imaging have rather high value,and when they are combined together to be applied for the diagnosis,the result is the best.