吴丽娟 刘婷 付霞

【摘要】 目的：探讨超声弹性成像（ultrasonic elastography，UE）联合常规超声（coventional ultrasonogaphy，CUS）对甲状腺结节（thyroid nodules，TN）的诊断价值。方法：选取2020年1月-2021年8月本院收治的TN患者202例，所有TN患者均在术前接受UE及CUS检查，并全部接受手术治疗。将手术病理组织学结果作为金标准，观察单独UE、CUS和UE联合CUS鉴别诊断TN的情况，比较三种检查方式鉴别诊断TN的临床效能。结果：组织病理学检查结果显示，所有患者共存在250个TN病灶，良性病灶184个，恶性病灶66个。UE共检查出恶性病灶74个，良性病灶176个。CUS共检查出恶性病灶86个，良性病灶164个。UE联合CUS检查出恶性病灶72个，良性病灶178个。UE联合CUS检查诊断TN的准确率、特异度及敏感度均显著高于单独UE及CUS检查（P<0.05）。结论：UE联合CUS检查可起到互补效果，有效提升临床中鉴别诊断TN良恶性的准确性，从而为临床诊断及治疗提供更多参考。

【关键词】 超声弹性成像 常规超声 甲状腺结节

Diagnostic Value of Ultrasonic Elastography Combined with Conventional Ultrasound in Thyroid Nodules/WU Lijuan， LIU Ting， FU Xia. //Medical Innovation of China， 2021， 18（32）： -164

[Abstract] Objective： To explore the diagnostic value of ultrasonic elastography （UE） combined with coventional ultrasonogaphy （CUS） in thyroid nodules （TN）. Method： A total of 202 TN patients admitted to our hospital from January 2020 to August 2021 were selected， all TN patients received UE and CUS examination before surgery， and all received surgical treatment. The differential diagnosis of TN by UE， CUS alone and UE combined with CUS was observed， and the clinical efficacy of the three examination methods was compared for TN differential diagnosis. Result： Histopathological examination results showed that there were 250 TN lesions， 184 benign lesions and 66 malignant lesions in all patients. A total of 74 malignant lesions and 176 benign lesions were detected by UE. CUS detected 86 malignant lesions and 164 benign lesions. UE combined with CUS detected 72 malignant lesions and 178 benign lesions. The accuracy， specificity and sensitivity of UE combined with CUS were significantly higher than those of UE and CUS alone （P<0.05）. Conclusion： UE combined with CUS can play a complementary role and effectively improve the accuracy of differential diagnosis of benign and malignant TN in clinical practice， thus providing more references for clinical diagnosis and treatment.

[Key words] Ultrasonic elastography Coventional ultrasonogaphy Thyroid nodules

First-author’s address： Fuzhou Third Hospital， Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2021.32.040

甲狀腺结节（thyroid nodules，TN）是临床内分泌科中较为常见的一种疾病[1]。相关流行病学调查指出，在所有成年人中，有4%～8%能够触及TN;而通过超声检查明确存在TN的比率为40%～50%，其中随访恶性的占比为5%～6%[2]。近年来临床中TN发病率持续升高，且逐渐呈现年轻化趋势[3]。目前临床中诊断并鉴别TN性质时的技术方法多种多样，常见的有电子计算机断层扫描（computed tomography，CT）、超声检查、磁共振成像（magnetic resonance imaging，MRI）、核素扫描法、穿刺细胞学检查及基因检测等;但是最常用的方式为细针抽吸活检及超声检查[4]。而超声作为一种非侵入性的检查方式，随着近年来不断发展的超声仪器设备，已经成为临床对TN诊断及鉴别的一种最常用方式，且优势独特[5]。……