甲狀腺良惡性結(jié)節(jié)診斷中超聲造影聯(lián)合彈性成像的應(yīng)用價值分析

王健　莊軍　鞏簫音　王澤　王芳

【摘要】 目的：對甲狀腺良惡性結(jié)節(jié)診斷中超聲造影聯(lián)合彈性成像的應(yīng)用價值進(jìn)行分析。方法：選取自2015年7月-2016年12月在本院接受治療的150例甲狀腺良結(jié)節(jié)患者，全部患者均接受常規(guī)超聲造影診斷、彈性成像診斷以及超聲造影聯(lián)合彈性成像診斷，診斷后，對比病理診斷結(jié)果，對三種方法的良、惡性結(jié)節(jié)診斷相符率進(jìn)行分析。結(jié)果：患者接受常規(guī)超聲造影診斷后，良性結(jié)節(jié)診斷相符率為81.8%，惡性結(jié)節(jié)診斷相符率為78.6%；患者接受超聲彈性成像診斷后，良性結(jié)節(jié)診斷相符率為86.4%，惡性結(jié)節(jié)診斷相符率為82.1%；患者接受超聲造影聯(lián)合彈性成像后，良性結(jié)節(jié)診斷相符率是98.5%，惡性結(jié)節(jié)診斷相符率為97.6%；超聲造影聯(lián)合彈性成像的診斷相符率明顯高于單獨(dú)的常規(guī)超聲和彈性成像診斷，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：超聲彈性診斷對于甲狀腺良、惡性結(jié)節(jié)的臨床診斷有著一定的價值，但是要想使臨床診斷準(zhǔn)確率得到進(jìn)一步提升，在甲狀腺良惡性結(jié)節(jié)的臨床診斷中必須采用超聲造影聯(lián)合彈性成像診斷。

【關(guān)鍵詞】 甲狀腺良惡性結(jié)節(jié)； 超聲造影； 彈性成像

Application Value of Contrast-enhanced Ultrasound and Elastography in Diagnosis of Benign and Malignant Thyroid Nodules/WANG Jian，ZHUANG Jun，GONG Xiao-yin，et al.//Medical Innovation of China，2017，14（22）：038-041

【Abstract】 Objective：To analyze the value of contrast-enhanced ultrasound and elastography in the diagnosis of benign and malignant thyroid nodules.Method：A total of 150 cases of benign thyroid nodules from July 2015 to December 2016 in our hospital were selected，all patients were given conventional contrast-enhanced ultrasound diagnosis，elastography diagnosis and contrast-enhanced ultrasound combined with elastography diagnosis.After diagnosis，compared with pathology diagnosis results，diagnosis corresponding rate of benign and malignant nodules of three groups were analysed.Result：The patients received routine ultrasonography diagnosis，diagnosis coincidence rate of benign nodules was 81.8%，diagnosis coincidence rate of malignant nodules was 78.6%；the patients received ultrasonic elastography diagnosis，diagnosis coincidence rate of benign nodules was 86.4%，diagnosis consistent rate of malignant nodules was 82.1%；underwent contrast-enhanced ultrasonography combined with elastography，diagnosis consistent rate of benign nodules was 98.5%，diagnosis coincidence rate of malignant nodules was 97.6%，the diagnosis coincidence rate of the contrast-enhanced ultrasound combined with elastography diagnosis was significantly higher than those of conventional contrast-enhanced ultrasound diagnosis and elastography diagnosis，the differences were statistically significant（P<0.05）.Conclusion：Elastography diagnosis has a certain value to the clinical diagnosis of thyroid benign and malignant nodules，but in order to further enhance the accuracy of clinical diagnosis，in clinical diagnosis of benign and malignant thyroid nodules，contrast-enhanced ultrasonography combined with elastography diagnosis must be used.

【Key words】 Benign and malignant thyroid nodules； Contrast-enhanced ultrasound； Elastic imagingendprint

First-authors address：The Chinese Peoples Liberation Army 264th Hospital，Taiyuan 030024，China

doi：10.3969/j.issn.1674-4985.2017.22.011

在臨床中，甲狀腺結(jié)節(jié)是一種較為常見的病癥，可以分為良性結(jié)節(jié)與惡性結(jié)節(jié)兩種。甲狀腺腫瘤具有病情隱匿性較強(qiáng)的特點(diǎn)，近三十年中，甲狀腺癌的病發(fā)率提高了約三倍，屬于增速非常快的一種惡性腫瘤，所以早期的發(fā)現(xiàn)與治療工作對預(yù)后有著非常重要的影響。甲狀腺結(jié)節(jié)的病變率較高，且病理特征較為復(fù)雜，所以盡早判斷出結(jié)節(jié)的良惡性質(zhì)對于確定具體治療方案意義重大。過去在診斷甲狀腺結(jié)節(jié)的性質(zhì)時，超聲檢查是主要手段，但是在具體臨床操作中，部分結(jié)節(jié)的表現(xiàn)并不明顯，例如內(nèi)部回聲混亂、形態(tài)不規(guī)則以及邊界模糊等，這種情況下單純采用超聲檢查已經(jīng)很難做出準(zhǔn)確的判斷。……