术前超声造影检查鉴别甲状腺良恶性结节的价值

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术前超声造影检查鉴别甲状腺良恶性结节的价值

作者：隋鑫甄景琴袁丽君

来源：《中国医药导报》2016年第16期

[摘要] 目的探讨术前超声造影（CEUS）在甲状腺良恶性结节鉴别诊断中的价值。方法

选取2010年9月～2015年9月在河北医科大学第三医院拟行外科手术治疗的甲状腺结节患者97例，共计109个结节，对所有甲状腺结节病灶进行超声造影检查，并经手术病理证实。分

析甲状腺结节超声造影的图像信息。以病理检查作为金标准，绘制ROC曲线，评估超声造影诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确度。结果超声造影诊断甲状腺良恶性结节的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为81.82%、90.70%、

93.10%、90.70%和85.32%。诊断甲状腺结节ROC曲线下面积为0.883。结论术前超声造影检查鉴别甲状腺良恶性结节具有较大的临床意义。

[关键词] 超声；超声造影；甲状腺良恶性结节；病理检查；鉴别诊断

[中图分类号] R736.1 [文献标识码] A [文章编号] 1673-7210（2016）06（a）-0116-04

[Abstract] Objective To explore the value of contrast-enhanced ultrasound （CEUS） in differential diagnosis of malignant and benign thyroid nodules. Methods A total of 97 patients with 109 thyroid nodules treated with surgery in the Third Hospital of Hebei Medical University from September 2010 to September 2015 were selected. All the thyroid nodules were examined by CEUS and confirmed by surgical pathologic. Image analysis of CEUS were performed. Postoperative pathological results were taken as golden standard， receiver operating characteristic （ROC） curve was draw. The sensitivity， specificity， positive predictive value （PPV）， negative predictive value （NPV） and accuracy of CEUS were assessed. Results The sensitivity， specificity， PPV，NPV and accuracy of CEUS for diagnosis of malignant and benign thyroid nodules were 81.82%，90.70%， 93.10%， 90.70% and 85.32%. The area under the ROC curve （AUC） for CEUS was 0.883. Conclusion Preoperative CEUS has great clinical significance for diagnosis of malignant and benign thyroid nodules.

[Key words] Ultrasound； Contrast-enhanced ultrasound； Malignant and benign thyroid nodules； Pathological examination； Differential diagnosis

甲状腺结节（thyroid nodular，TN）发病率日益增高，男女发病率为11.3/10万人次和

4.1/10万人次[1]。超声检查已成为甲状腺疾病的首选方法[2]，但甲状腺良恶性结节的常规超声鉴别存在局限性[3]。超声造影技术作为超声新技术，可以动态观察肿瘤内部血流灌注情况，

正在被应用于甲状腺肿瘤的特征评估中[4-6]。使用超声造影动态评估微循环与彩色及能量多普