目的：探讨弹性成像（UE）与超声造影（CEUS）两种检查技术对鉴别诊断甲状腺微小乳头状癌（PTMC）的价值。方法：对常规超声检测出且定性困难的98例109个甲状腺微小结节进行弹性成像及超声造影检查，所有结节均经手术病理证实。比较两种检查方法的准确性。结果：109个结节中超声造影诊断正确率为84．4％（92／109），其中8例恶性结节误诊为良性结节，11例良性结节误诊为恶性结节；弹性成像5分法诊断正确率为92．7％（101／109），其中3例恶性结节误诊为良性结节，5例良性结节误诊为恶性结节。弹性成像诊断甲状腺微小癌的敏感性95．38％，特异性88．64％，准确性92．86％；CEUS 诊断甲状腺微小癌的敏感性87．69％，特异性75％，准确性82． 57％。弹性成像和超声造影对 PTMC 的诊断的准确率比较有显著差异（P ＜0．05）。结论：超声造影和弹性成像对于诊断 PTMC 方面均有价值，但弹性成像≥3评分作为诊断 PTMC 的诊断价值高于超声造影。%Objective :To assess the diagnosis value of ultrasonic elastography(UE) and contrast‐enhanced ultrasound (CEUS) in thyroid papillary carcinoma (PTMC) .Methods :UE and CEUS were made on 98 cases of 109 thyroid nodules which were tested by conventional ultrasonic and difficult to diagnose .All nodules from operation were confirmed by pathologic examination .Accuracy of both ultrasonic methods was compared .Results :In these 109 nodules ,the accuracy rate of CEUS was 84 .4% (92/109) ,8 malignant nodules were misdiagnosed as benign , and 11 benign nodules were misdiagnosed as malignant .The accuracy of 5‐point scale criteria of UE was 92 .7%(101/109) ,3 malignant nodules were misdiagnosed as benign ,and 5 benign nodules were misdiagnosed as malig‐nant .UE in the diagnosis of PTMC displayed a sensitivity of 95 .38% ,a specificity of 88 .64% and an accuracy of 92 .86% .CEUS displayed a sensitivity of 87 .69% ,a specificity of 75% and an accuracy of 82 .57% .UE in the diag‐nosis of PTMC had a more significant advantage than CEUS .(P < 0 .05) Conclusion :Both CEUS and UE had ad‐vantage in diagnosis of PTMC .But using UE score ≥ 3 as criteria of diagnosis of PTMC had higher practical value .
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