CAJ | 학술논문

目的确定高分辨率超声、超声弹性成像和超声造影鉴别甲状腺结节良恶性病变的诊断指标,评估其临床应用价值.方法选取行手术治疗的甲状腺结节患者63例,术前予高分辨率超声、弹性成像和造影检查.根据术后病理结果区分良恶性病变,筛选有价值的检测指标,构建受试者工作特征曲线确定诊断标准.结果 (1)高分辨率超声中有意义的指标为结节低回声、结节回声不均、边界不清、形态不规则、纵横比≥1以及结节内细小点状钙化(均P＜0.05).(2)超声弹性成像分级评分在良恶性病变之间差异有显著统计学意义(P＜0.05).(3)超声造影有意义的指标为强化边界不清和强化形态不规则(均P＜0.05).(4)高分辨率超声的诊断标准为符合6个指标中的任意3个,敏感性80.0％,特异性77.6％,准确性78.6％.弹性成像诊断标准为弹性评分≥3分,敏感性48.6％,特异性83.7％,准确性69.0％.超声造影的诊断标准为符合2个指标中任意1个,敏感性68.6％,特异性82.5％,准确性为76.0％.结论在甲状腺结节良恶性病变的鉴别诊断中,高分辨率超声具有较高的敏感性和准确性,超声弹性成像和超声造影的特异性较高.
목적 학정고분변솔초성、초성탄성성상화초성조영감별갑상선결절량악성병변적진단지표,평고기림상응용개치.방법 선취행수술치료적갑상선결절환자63례,술전여고분변솔초성、탄성성상화조영검사.근거술후병리결과구분량악성병변,사선유개치적검측지표,구건수시자공작특정곡선학정진단표준.결과 (1)고분변솔초성중유의의적지표위결절저회성、결절회성불균、변계불청、형태불규칙、종횡비≥1이급결절내세소점상개화(균P＜0.05).(2)초성탄성성상분급평분재량악성병변지간차이유현저통계학의의(P＜0.05).(3)초성조영유의의적지표위강화변계불청화강화형태불규칙(균P＜0.05).(4)고분변솔초성적진단표준위부합6개지표중적임의3개,민감성80.0％,특이성77.6％,준학성78.6％.탄성성상진단표준위탄성평분≥3분,민감성48.6％,특이성83.7％,준학성69.0％.초성조영적진단표준위부합2개지표중임의1개,민감성68.6％,특이성82.5％,준학성위76.0％.결론 재갑상선결절량악성병변적감별진단중,고분변솔초성구유교고적민감성화준학성,초성탄성성상화초성조영적특이성교고.
Objective To determine the diagnostic criteria of high resolution ultrasound,ultrasound elasticity imaging,and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant lesions in thyroid nodules and assess their clinical efficacy.Method Sixty-three patients with thyroid nodules underwent high resolution ultrasound,elasticity imaging,and contrast-enhanced ultrasound examinations before surgery.Distinguishing benign from malignant lesions was based on pathological results.Valuable indicators from the examinations were screened and patients' occupational characteristic curves were made.Results (1) The significant indicators of high resolution ultrasound in differential diagnosis of thyroid nodules were hypoechoic nodules,uneven echo,ill-defined,irregular shape,aspect ratio ≥ 1 and punctate calcification within the nodule (P＜0.05).(2) The elastosonography grading score had significant differences between benign and malignant lesions (P＜0.05).(3) The meaningful indicators of contrast-enhanced ultrasound were the unclear enhanced border and the irregular enhanced shape (P＜0.05).(4) The diagnostic criteria of high-resolution ultrasound met any three of six indicators,with the sensitivity,specificity,and accuracy of 80.0％,77.6％,and 78.6％ respectively.The diagnostic criterion of elastography was the elasticity score ≥ 3 points,with the sensitivity,specificity,and accuracy were 48.6％,83.7％,and 69.0％ respectively.The diagnostic criteria of contrast-enhanced ultrasound were complying with any one of two indicators,with the sensitivity,specificity,and accuracy of 68.6％,82.5％,and 76.0％ respectively.Conclusions The high-resolution ultrasound may yield higher sensitivity and accuracy in the differential diagnosis of benign and malignant lesions in thyroid nodules,while ultrasound elasticity imaging and contrast-enhanced ultrasound may offer a higher specificity.