超声弹性成像技术在甲状腺癌诊断中的应用价值(1)
【摘要】 目的：分析超声弹性成像技术在甲状腺癌诊断中的应用价值。方法：选取2015年6月-2016年5月在本院甲状腺科就诊的931例患者为研究对象。对所有患者进行彩色多普勒和弹性成像检查，以后期的手术病理为标准，对两种检查的诊断准确率作出比较。结果：超声结果显示931例患者总钙化率为36.0%(329/931)，其中粗大钙化占33.7%(111/329)，微小钙化占60.5%(199/329)，环状钙化占5.8%(19/329)。病理结果显示，931例患者中甲状腺良性疾病787例，合并钙化者211例(26.8%)，甲状腺癌144例，合并钙化者118例(81.9%)；合并钙化者在甲状腺良、恶性肿瘤中所占比率比较差异有统计学意义( 字2=161.931，P<0.001)。超声检查合并钙化灶患者中甲状腺癌阳性率为35.9%，弹性成像技术中Ⅲ～Ⅳ级结果中甲状腺癌阳性率为93.9%，后者诊断阳性率高于前者，差异有统计学意义( 字2=91.761，P<0.001)。结论：超声弹性成像技术能够半定量地对肿块性质作出评价，对于甲状腺癌的诊断具有重要价值。在传统彩色多普勒超声检查基础上，结合弹性成像技术，能显著提高甲状腺癌的准确率和特异性。
【关键词】 甲状腺结节； 钙化； 超声弹性成像技术； 甲状腺癌
Application Value of Ultrasonic Elastography in the Diagnosis of Thyroid Cancer/XIAO Li-xia，MEI Feng，ZHONG Rui-fang，et al.//Medical Innovation of China，2016，13(20)：057-059
【Abstract】 Objective：To study the application value of ultrasonic elastography in the diagnosis of thyroid cancer.Method：The 931 patients treated from June 2015 to May 2016 in the thyroid department were selected.All the patients received the color Doppler ultrasound and ultrasonic elastography.The patients were confirmed by the surgical pathology.The accuracy based on two methods was comapred.Result：The total rate for calcification cases was 36.0%(329/931) of which the bulky cases accounted for 33.7%(111/329)；the tiny cases accounted for 60.5%(199/329)；the cyclic cases accounted for 5.8%(19/329)；there were 787 benign cases，211 complicated cases of calcification(26.8%)，144 thyroid cancer cases and 118 complicated cases of calcification (81.9%).Merger of calcification in the proportion of benign and malignant thyroid tumors was compared，the difference was statistically significant ( 字2=161.931，P<0.001).For patients complicated with calcification，the positive rate of thyroid cancer was 35.9%，according to the ultrasonic elastography，the positive rate of stage Ⅲ-Ⅳ thyroid cancer was 93.9%( 字2=91.761，P<0.001).Conclusion：The ultrasonic elastography can make a semi-quantitative diagnosis on the nature of lump and have an important value in the diagnosis of thyroid cancer.The combined methods of color Doppler ultrasound and ultrasonic elastography can greatly improve the accuracy and specificity of thyroid cancer.
【Key words】 Thyroid nodule； Calcification； Ultrasonic elastography； Thyroid cancer
First-author’s address：Dongfeng People’s Hospital of Zhongshan City，Zhongshan 528425，China
doi：10.3969/j.issn.1674-4985.2016.20.015
甲状腺占位性病变为临床常见病，而甲状腺癌的发病率逐年上升，其中临床确诊的结节中约5%为恶性，早期发现病灶并鉴其良恶性对临床治疗及手术选择有重要意义[1]。研究发现，甲状腺结节内钙化与甲状腺癌的发生有密切联系[2]。超声检查甲状腺结节钙化情况已成为临床初步诊断甲状腺癌的主要方法之一[3]。超声弹性成像是近年来发展的一项新技术。文献[4]报道，应用实时组织弹性成像技术鉴别甲状腺结节的良恶性敏感性与特异性分别为92%、90%。本研究对2015年6月-2016年5月本科在甲状腺检查中发现的结节性病变进行弹性成像，并根据钙化情况、弹性成像特点等进行良恶性评价。对所有研究对象进行追踪、随访，以手术病理为标准，回顾性研究甲状腺结节内钙化情况结合超声弹性成像特点诊断甲状腺癌的临床应用价值。, 百拇医药(萧利霞 梅峰 钟瑞芳 杨桂兰 郑美容)
【关键词】 甲状腺结节； 钙化； 超声弹性成像技术； 甲状腺癌
Application Value of Ultrasonic Elastography in the Diagnosis of Thyroid Cancer/XIAO Li-xia，MEI Feng，ZHONG Rui-fang，et al.//Medical Innovation of China，2016，13(20)：057-059
【Abstract】 Objective：To study the application value of ultrasonic elastography in the diagnosis of thyroid cancer.Method：The 931 patients treated from June 2015 to May 2016 in the thyroid department were selected.All the patients received the color Doppler ultrasound and ultrasonic elastography.The patients were confirmed by the surgical pathology.The accuracy based on two methods was comapred.Result：The total rate for calcification cases was 36.0%(329/931) of which the bulky cases accounted for 33.7%(111/329)；the tiny cases accounted for 60.5%(199/329)；the cyclic cases accounted for 5.8%(19/329)；there were 787 benign cases，211 complicated cases of calcification(26.8%)，144 thyroid cancer cases and 118 complicated cases of calcification (81.9%).Merger of calcification in the proportion of benign and malignant thyroid tumors was compared，the difference was statistically significant ( 字2=161.931，P<0.001).For patients complicated with calcification，the positive rate of thyroid cancer was 35.9%，according to the ultrasonic elastography，the positive rate of stage Ⅲ-Ⅳ thyroid cancer was 93.9%( 字2=91.761，P<0.001).Conclusion：The ultrasonic elastography can make a semi-quantitative diagnosis on the nature of lump and have an important value in the diagnosis of thyroid cancer.The combined methods of color Doppler ultrasound and ultrasonic elastography can greatly improve the accuracy and specificity of thyroid cancer.
【Key words】 Thyroid nodule； Calcification； Ultrasonic elastography； Thyroid cancer
First-author’s address：Dongfeng People’s Hospital of Zhongshan City，Zhongshan 528425，China
doi：10.3969/j.issn.1674-4985.2016.20.015
甲状腺占位性病变为临床常见病，而甲状腺癌的发病率逐年上升，其中临床确诊的结节中约5%为恶性，早期发现病灶并鉴其良恶性对临床治疗及手术选择有重要意义[1]。研究发现，甲状腺结节内钙化与甲状腺癌的发生有密切联系[2]。超声检查甲状腺结节钙化情况已成为临床初步诊断甲状腺癌的主要方法之一[3]。超声弹性成像是近年来发展的一项新技术。文献[4]报道，应用实时组织弹性成像技术鉴别甲状腺结节的良恶性敏感性与特异性分别为92%、90%。本研究对2015年6月-2016年5月本科在甲状腺检查中发现的结节性病变进行弹性成像，并根据钙化情况、弹性成像特点等进行良恶性评价。对所有研究对象进行追踪、随访，以手术病理为标准，回顾性研究甲状腺结节内钙化情况结合超声弹性成像特点诊断甲状腺癌的临床应用价值。, 百拇医药(萧利霞 梅峰 钟瑞芳 杨桂兰 郑美容)