韦玉亚 姜伟 朱婷

【摘要】 目的：探讨实时超声弹性成像配合灰阶超声在诊断甲状腺疾病中的临床价值。方法：选取2018年1-12月在本院诊断为甲状腺单发实性结节并进行手术病理检查的患者70例，手术前对所有患者进行灰阶超声及实时弹性超声成像检查，病理结果为金标准，比较实时弹性超声成像、灰阶超声及联合检查对甲状腺疾病定性诊断的灵敏度、特异度及准确度。结果：所选甲状腺单发实性结节患者病理结果显示，恶性肿瘤30例（乳头状癌14例、滤泡癌8例、髓样癌5例、腺癌3例）、良性肿瘤40例（甲状腺肿24例、甲状腺炎8例、甲状腺功能亢进8例）;灰阶超声诊断的灵敏度为53.33%、特异度为45.00%、准确度为48.57%;实时超声弹性成像灵敏度为83.33%、特异度为80.00%、准确度为81.43%;联合两种超声检查的灵敏度为93.33%、特异度为92.50%、准确度为92.86%。结论：联合实时超声弹性成像、灰阶超声对甲状腺疾病的定性诊断价值明显高于单一灰阶超声或实时超声弹性成像检查，在临床有一定的应用价值。

【关键词】 实时超声弹性成像; 灰阶超声; 甲状腺结节疾病

【Abstract】 Objective：To explore the clinical value of real-time ultrasound elastography combined with gray-scale ultrasound in the diagnosis of thyroid disease.Method：Seventy patients with surgical pathological examination of single thyroid solid nodules from January to December 2018 in our hospital were selected，gray-scale ultrasound and real-time elastic ultrasound imaging were performed on all selected patients before surgery，the pathological result was the gold standard，the sensitivity，specificity and accuracy of real-time elastic ultrasound imaging，gray-scale ultrasound and combined examination for qualitative diagnosis of thyroid diseases were compared.Result：There were 30 cases of malignant tumors in the selected thyroid solid nodules（14 cases of papillary carcinoma，8 cases of follicular carcinoma，5 cases of medullary carcinoma，3 cases of adenocarcinoma），40 cases of benign tumors（24 cases of goiter，8 cases of thyroiditis，8 cases of hyperthyroidism）.The sensitivity of gray-scale ultrasound diagnosis was 53.33%，specificity was 45.00%，accuracy was 48.57%;real-time ultrasound elastography sensitivity was 83.33%，specificity was 80.00%，accuracy was 81.43%;sensitivity of combining two kinds of ultrasound examination was 93.33%，specificity was 92.50%，accuracy was 92.86%.Conclusion：The value of combined real-time ultrasound elastography and gray-scale ultrasound in the qualitative diagnosis of thyroid disease is significantly higher than that of single gray-scale ultrasound or real-time ultrasound elastography，it has certain application value in clinic.

【Key words】 Real-time ultrasound elastography; Gray-scale ultrasound; Thyroid nodule disease

First-authors address：The Peoples Hospital of Nanshan District in Shenzhen，Shenzhen 518052，China

doi：10.3969/j.issn.1674-4985.2019.17.026

甲狀腺是人类非常重要的分泌激素的浅表器官，当其激素分泌亢进或者减退均会引起甲状腺疾病[1]。严重的甲状腺疾病可导致机体激素分泌紊乱，给患者带来严重的危害，因此早期准确的判断甲状腺疾病的性质、特点并做出准确的治疗尤为重要[2]。超声检查是目前诊断甲状腺疾病的首选方法，超声技术能监测甲状腺结节及甲状腺实质的位置、大小、形态、动态血流情况[3]。……