Objective The purpose of this study is to evaluate the ability of real-time ultrasound elastography (UE) in diagnosing solid thyroid nodules and cervical lymphadenopathy. Methods Conventional ultrasound and UE were performed in 61 patients with 136 solid thyroid nodules and 17 cervical lymph nodes. At UE, elastoultrasono-graphic grades were classified into I-IV grades. The results were compared with pathologic findings. Results Pathologic results: 111 thyroid nodules were benign, 25 were malignant; 11 lymph nodes were metastatic, 6 were reactive. UE results: 106 thyroid nodules were grade I - II (104 were benign. 2 were malignant) .while 30 were grade ffl-IV (23 were malignant, 7 were benign). 9 cervical lymph nodes were grade I -II (6 were reactive, 3 were metastatic), while 8 were grade DI"IV (all were metastatic). Taking the elasticity grade I or IV as malignant standard, the thyroid nodule diagnostic sensitivity was 95. 8% , specificity was 93. 6%. UE and conventional ultrasonography were of significant difference statistically. Meanwhile, the lymph node diagnostic sensitivity was 72. 7%, specificity was 100%, which were higher than those of conventional ultrasonography, but without significant statistical difference. Conclusions UE has high value in diagnosing thyroid solid nodules, but still need to combine with conventional ultrasonography to improve the diagnosing accuracy of cervical lymphadenopathy.%目的 探讨实时超声弹性成像对甲状腺实性结节的定性诊断及判断淋巴结转移能力的价值.方法 对61例136个甲状腺实性结节和17枚颈部淋巴结行二维及弹性超声检查,将弹性图像分Ⅰ～Ⅳ级,其结果分别与病理结果对照.结果 病理结果:136个甲状腺结节中,良性111个,恶性25个；17枚淋巴结中,转移11枚,反应性6枚.超声弹性成像结果:136个甲状腺结节中Ⅰ～Ⅱ级106个(104个良性,2个恶性),Ⅲ～Ⅳ级30个(23个恶性,7个良性)；17枚淋巴结中Ⅰ～Ⅱ级9枚(6枚反应性,3枚转移),Ⅲ～Ⅳ级8枚(均为转移).以弹性分级Ⅲ～Ⅳ级为高度恶性预测指标,其诊断甲状腺恶性结节的敏感度95.8％,特异度93.6％,与常规超声检查结果比较差异有统计学意义(P＜0.05)；而其诊断转移淋巴结的敏感度72.7％,特异度100％,高于常规超声检查结果,但差异无统计学意义(P＞0.05).结论 实时超声弹性成像技术在甲状腺实性结节的定性诊断中具有较高的应用价值.在对颈部淋巴结定性诊断方面,与常规二维超声结合可进一步提高诊断的准确性.
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