目的 分析高频超声弹性检查诊断甲状腺结节良、恶性的价值.方法 回顾性分析2016年1月至12月56例甲状腺结节疾病患者临床资料,对56例患者的73个甲状腺结节分别采取高频超声弹性成像检查以及高频超声血流分级检查,将两种检查结果与术后病理检查结果对比分析,观察两种结果对判断甲状腺结节良恶性的价值,同时将两种检查结果结合分析作出联合诊断结果,判断联合诊断鉴别甲状腺结节性质的价值.结果 高频超声弹性检查、血流分级及二者联合检查的诊断结果与金标准比较差异均无统计学意义(P>0.05).高频超声弹性检查与血流分级联合诊断结果的准确率、敏感性最高,分别为95.89％,93.75％;高频超声弹性检查与联合诊断的特异性一致且最高均为97.56％.联合检查曲线下面积最大为0.957,诊断界值为1.5分;弹性检查曲线下面积为0.952,诊断界值为3.5分;血流分级曲线下面积为0.925,诊断界值为2.5分;提示联合检查为最佳诊断方法.结论 高频超声弹性检查应用于甲状腺结节的性质鉴别诊断中具有较高的准确性、特异性及敏感性,但联合血流分级诊断结果可进一步提高诊断的准确性、特异性与敏感性,值得在甲状腺结节的良恶性超声诊断中推广应用.%Objective To evaluate the value of high frequency ultrasound elastography in the diagnosis of benign and malignant thyroid nodules. Methods A retrospective analysis of the clinical data of 56 cases of thyroid disease in our hospital from March 2014 to March 2015 were taken respectively,high frequency ultrasound elasticity imaging and high frequency ultrasound blood flow grading examination of 73 thyroid nodules in 56 patients,two test diagnosis results were compared with postoperative pathology analysis,observation of two results to determine the value of benign and malignant thyroid nodules,and two test results combined with the analysis made joint diagnosis results,judged the combined diagnosis results for the screening value of thyroid nodules. Results There was no statistically significant difference between the diagnostic results of high frequency ultrasound elastography,blood flow classification and two joint examination and the gold standard,P>0.05. The highest accuracy rate of high frequency ultrasound elastography combined with blood flow classification was 95.89％ and the sensitivity was the highest. The specificity of the high frequency ultrasound elastography and the joint diagnosis were the same and the highest was 97.56％ (93.75％). The area under the curve of the maximum joint inspection was 0.957,the diagnostic value of 1.5 points;the elastic area checked under the curve was 0.952,the diagnostic value of 3.5 points;the blood flow area under the curve was 0.925,the diagnostic value of 2.5 points;the combined examination was the best diagnostic method. Conclusion High frequency ultrasound elastography is of high accuracy, specificity and sensitivity in the differential diagnosis of thyroid nodules, but the combined flow classification diagnosis results can further improve the accuracy, specificity and sensitivity of the diagnosis, and deserve to be popularized and applied in the diagnosis of benign and malignant thyroid nodules.
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