临床荟萃 ›› 2016, Vol. 31 ›› Issue (3): 296-298.doi: 10.3969/j.issn.1004-583X.2016.03.016

• 论著 • 上一篇    下一篇

超声弹性成像鉴别诊断甲状腺实性小结节

丹海俊,张作阳,吴月娥,陈赞,翟书梅   

  1. 河北医科大学第二医院 体检科,河北 石家庄 050000
  • 收稿日期:2015-11-09 出版日期:2016-03-05 发布日期:2016-04-18
  • 通讯作者: 丹海俊,Email:danhaijun@163.com
  • 基金资助:
    河北省医学科学研究重点课题(ZL20140338)

Differential diagnosis of small solid thyroid nodules using ultrasound elastography

Dan Haijun, Zhang Zuoyang, Wu Yue’e, Chen Zan, Zhai Shumei   

  1. Department of Physical Examination, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Received:2015-11-09 Online:2016-03-05 Published:2016-04-18
  • Contact: Dan Haijun, Email: danhaijun@163.com

摘要: 目的 探讨实时超声弹性成像对常规超声定性困难的甲状腺单发实性小结节良恶性的鉴别诊断价值。方法 甲状腺单发实性小结节(最大直径≤15 mm)患者82例,行常规二维超声及彩色多普勒超声检查良恶性鉴别困难的,最后进行实时超声弹性成像检查,将弹性图分为Ⅰ~Ⅴ级,以病理结果为金标准进行比较。结果 实时超声弹性成像检查结果显示:Ⅰ~Ⅱ级12例,均为良性;Ⅲ级13例(良性5例,恶性8例); Ⅳ~Ⅴ级57例(良性3例,恶性54例)。以弹性分级Ⅳ ~Ⅴ级作为诊断甲状腺癌的预测指标,其特异度85.0%,灵敏度87.1%,准确率86.6%,阳性预测值94.7%,阴性预测值68.0%。结论 实时超声弹性成像对常规超声定性困难的甲状腺单发实性小结节良恶性鉴别有较高的诊断价值。

关键词: 甲状腺结节, 超声检查, 弹性成像技术

Abstract: Objective To explore the differential diagnostic value of real-time ultrasound elastography (USE) on single solid thyroid nodules (≤15 mm in maximum diameter) which are difficult to diagnose with conventional ultrasound.Methods A total of 82 patients with small single solid thyroid nodules were performed with two-dimensional and color Doppler ultrasound. Each patient was then examined by real-time USE, and the findings on elastography were classified into grade Ⅰ-Ⅴ. Ultrasonographic results were compared with histopathologic data.Results Twelve patients were found with benign lesion ranging from grade Ⅰ to Ⅱ, thirteen patients were found with grade Ⅲ (5 benign and 8 carcinoma); fifty-seven patients were found with grade Ⅳ and Ⅴ (3 benign and 54 carcinoma). Small solid thyroid nodules with grade Ⅳ and Ⅴ were diagnosed as thyroid cancer with the specificity 85.0%, sensitivity 87.1%, and accuracy 86.6%. The positive and negative predictive values were 94.7% and 68.0%.Conclusion Real-time USE seems to have great value for differential diagnosis of small single solid thyroid nodules ≤15 mm in maximum diameter than conventional ultrasound.

Key words: thyroid nodule, ultrasonography, elastography

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