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目的探讨超声弹性成像和常规超声在桥本甲状腺合并结节中的诊断价值。方法选取2013年1月至2014年12月间青岛市第三人民医院收治的42例经术后病理证实为桥本甲状腺炎合并结节的患者,同时接受常规超声和超声弹性成像检查,对两种诊断方法结果进行观察记录。以手术后病例诊断结果为准,对超声弹性成像和常规超声的诊断结果进行分析比较。结果42例患者共有48个病灶,其中恶性结节32个,平均直径为(1.30±0.62)cm;良性结节16个,平均直径为(1.40±0.56)cm,良恶性结节直径比较,差异无统计学意义(P>0.05)。32个恶性结节中,常规超声诊断恶性19个,良性13个;超声弹性成像诊断恶性30个,良性2个。16个良性结节中,常规超声诊断恶性3个,良性13个;超声弹性成像诊断恶性2个,良性14个。常规超声敏感度为59.4%,特异性为81.3%,阳性预测值为86.4%,阴性预测值为50.0%,符合率为66.7%。超声弹性成像敏感度为93.8%,特异性为87.5%,阳性预测值为93.8%,阴性预测值为87.5%,符合率为91.7%。结论在桥本甲状腺炎合并结节性质的诊断中,超声弹性成像敏感度高,具有较高的诊断价值。
Objective To investigate the diagnostic value of elastography and routine ultrasound in the nodules of Hashimoto thyroid. Methods Forty-two patients with pathologically confirmed Hashimoto’s thyroiditis complicated with nodules from January 2013 to December 2014 in Qingdao Third People’s Hospital were enrolled in this study. The patients underwent routine ultrasound and ultrasound elastography examinations. The diagnosis results were observed and recorded. After the diagnosis of postoperative cases prevail, the results of ultrasonic elastography and conventional ultrasound analysis and comparison. Results There were 48 lesions in 42 patients, including 32 malignant nodules with an average diameter of (1.30 ± 0.62) cm. There were 16 benign nodules with an average diameter of (1.40 ± 0.56) cm. The diameters of benign and malignant nodules were significantly different No statistical significance (P> 0.05). Of the 32 malignant nodules, 19 were malignant and 13 were diagnosed by conventional ultrasonography; 30 were malignant by ultrasound elastography and 2 were benign. Among the 16 benign nodules, 3 were malignant and 13 were diagnosed by conventional ultrasound, 2 were diagnosed as malignant by ultrasound elastography and 14 were benign. Conventional ultrasound sensitivity was 59.4%, specificity was 81.3%, positive predictive value was 86.4%, negative predictive value was 50.0%, the coincidence rate was 66.7%. Sensitivity of ultrasound elastography was 93.8%, specificity was 87.5%, positive predictive value was 93.8%, negative predictive value was 87.5%, the coincidence rate was 91.7%. Conclusion In the diagnosis of Hashimoto’s thyroiditis complicated with nodules, ultrasound elastography has high sensitivity and high diagnostic value.