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目的探讨超声造影(CEUS)及声辐射力脉冲成像技术(ARFI)对甲状腺良恶性结节的诊断价值。方法对88个甲状腺结节进行CEUS,分析其超声造影表现。并应用ARFI对甲状腺结节的硬度进行评估,获得结节内部及周边正常甲状腺组织的SWV值,通过绘制ROC曲线获得SWV值的曲线下面积及诊断界限值。评估各诊断方法的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率。所有病例均经病理证实。结果 88个结节中恶性29个,良性59个。CEUS诊断甲状腺恶性结节的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为79.3%、91.5%、82.1%、90%、87.5%。以2.565 m/s作为诊断界限值,ARFI诊断甲状腺恶性结节的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为75.9%、94.9%、88.0%、88.9%、88.6%,AUC为0.878,CEUS与ARFI两种检查无统计学差异,但两者结合诊断甲状腺恶性结节的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为93.1%、89.8%、81.8%、96.3%、90.9%,分别高于CEUS及ARFI检查。结论 CEUS及ARFI对甲状腺良恶性结节有一定的鉴别诊断价值,二者联合可以提高诊断的符合率。
Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) and acoustic radiation pulse imaging (ARFI) in benign and malignant thyroid nodules. Methods Eighty-eight thyroid nodules were examined by CEUS and analyzed by echocardiography. ARFI was used to evaluate the hardness of thyroid nodules. The SWV of thyroid tissue in and around the nodules was obtained. The area under the curve and the diagnostic limit of SWV were obtained by ROC curve. Evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of each diagnostic method. All cases were pathologically confirmed. Results Of the 88 nodules, 29 were malignant and 59 were benign. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate of CEUS in diagnosis of thyroid malignant nodules were 79.3%, 91.5%, 82.1%, 90% and 87.5%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate of ARFI in diagnosing thyroid malignant nodules were 75.9%, 94.9%, 88.0%, 88.9%, 88.6%, respectively, with 2.565 m / AUC was 0.878, there was no significant difference between CEUS and ARFI, but the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate of combining the two in detecting malignant thyroid nodules were 93.1%, 89.8%, 81.8 %, 96.3%, 90.9% respectively, higher than CEUS and ARFI. Conclusions CEUS and ARFI have some differential diagnostic value for benign and malignant thyroid nodules. The combination of the two can improve the coincidence rate of diagnosis.