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目的比较常规超声与超声弹性成像鉴别甲状腺良恶性结节的影像特征及其诊断价值。方法纳入2013年6月至2015年5月于我院内分泌科因甲状腺结节就诊并行超声引导下细针穿刺(FNA)细胞学检查的患者618例,以甲状腺FNA结果为标准,比较常规超声与超声弹性成像用于鉴别良恶性甲状腺结节的影像特征及其诊断价值。结果本研究共纳入甲状腺结节患者609例(772枚结节),其中良性结节632枚,恶性140枚。经分析,常规超声特征中,结节实性、结节低回声、欠清晰边界、微钙化、纵横比≥1在恶性结节中的发生率显著高于良性结节(P<0.05),满足任意三项超声特征,诊断灵敏度为72.86%,特异性为59.18%,准确度为61.66%;超声弹性成像技术以弹性应变率比值(SR)1.895为最佳诊断点,灵敏度为77.03%,特异性为56.10%,准确度为60.94%;两者联合诊断时,灵敏度为52.70%,特异性为66.67%。结论在甲状腺结节的良恶性鉴别诊断中,常规超声是结节评估的基本方法,超声弹性成像作为超声新技术,在结节良恶性鉴别中也有一定作用。
Objective To compare the imaging features of benign and malignant thyroid nodules and their diagnostic value by conventional ultrasound and elastography. Methods A total of 618 patients with endoscopic thyroid nodules undergoing ultrasound-guided fine needle aspiration (FNA) cytology in our hospital from June 2013 to May 2015 were enrolled. Thyroid FNA results were used as a standard to compare conventional ultrasound with Ultrasound elastography is used to identify the imaging features of benign and malignant thyroid nodules and its diagnostic value. Results A total of 609 thyroid nodules (772 nodules) were included in this study, including 632 benign nodules and 140 malignant nodules. According to the analysis, in conventional ultrasound features, the incidence of nodular solidity, hypoechoic nodules, undefined boundaries, microcalcification, and aspect ratio≥1 in malignant nodules were significantly higher than those in benign nodules (P <0.05) The diagnostic sensitivity was 72.86%, the specificity was 59.18% and the accuracy was 61.66%. Ultrasound elastography was the best diagnostic point with elastic strain rate ratio (SR) 1.895, the sensitivity was 77.03%. The specificity 56.10% with accuracy of 60.94%. When the two were combined, the sensitivity was 52.70% and the specificity was 66.67%. Conclusion In the differential diagnosis of benign and malignant thyroid nodules, conventional ultrasound is the basic method of nodule evaluation. Ultrasound elastography as a new ultrasound technique has a certain role in benign and malignant nodules.