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目的探讨超声造影对不同病理类型甲状腺可疑结节的诊断价值。方法选取2015年6月至2016年8月于深圳市光明新区人民医院行超声造影检查的甲状腺患者382例(结节482个),均实施超声造影检查,以病理诊断结果为金标准,分析超声造影对良、恶性结节不同病理类型诊断情况。结果超声造影检查敏感性为91.5%(335/366)、特异性为65.2%(58/89)、阳性预测值85.2%(335/393)、阴性预测值65.2%(58/89)、准确性为81.5%(393/482);恶性结节中,超声造影对乳头状癌诊断符合率最高,其次为微小乳头状癌,对乳头状癌合并结节性甲状腺肿诊断符合率最低;超声造影对不同病理类型恶性结节诊断检出率比较,差异有统计学意义(P<0.05);良性结节中,超声造影对结节性甲状腺肿符合率最高,对桥本氏甲状腺炎诊断符合率最低,但超声造影对不同病理类型良性结节诊断检出率相比,差异无统计学意义(P>0.05)。结论超声造影对甲状腺微小乳头状癌、乳头状癌诊断准确率较高,对乳头状癌合并结节性甲状腺肿诊断准确率较低;超声造影对甲状腺良性结节不同病理类型的诊断结果无明显差异。
Objective To investigate the diagnostic value of contrast-enhanced ultrasound in the diagnosis of suspicious thyroid nodules of different pathological types. Methods From June 2015 to August 2016, 382 thyroid patients (482 nodules) underwent contrast echocardiography in People ’s Hospital of Guangming New District, Shenzhen City were enrolled in this study. The results of ultrasonography were taken and pathological diagnosis was taken as the gold standard. Angiography of benign and malignant nodules in different pathological diagnosis. Results The sensitivity, specificity and accuracy of contrast-enhanced ultrasound were 91.5% (335/366), 65.2% (58/89), 85.2% (335/393), and 65.2% (58/89) (81.5%, 393/482). In malignant nodules, CEUS had the highest coincidence rate in diagnosis of papillary carcinoma, followed by minimal papillary carcinoma, and the lowest coincidence rate in diagnosis of papillary carcinoma with nodular goiter. The detection rate of malignant nodules in different pathological types was statistically significant (P <0.05). Among benign nodules, the coincidence rate of CEUS and nodular goiter was the highest, and the lowest coincidence rate of Hashimoto’s thyroiditis , But there was no significant difference in the diagnostic rate of contrast-enhanced ultrasound in different pathological types of benign nodules (P> 0.05). Conclusions Contrast-enhanced ultrasound (CEUS) has a high diagnostic accuracy for papillary thyroid carcinoma and papillary carcinoma, and has a low diagnostic accuracy for papillary carcinoma combined with nodular goiter. There is no significant difference in the diagnostic value of CEUS between different pathological types of benign thyroid nodules difference.