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目的探讨超声实时弹性成像(UE)及声触诊组织量化技术对甲状腺良恶性结节的鉴别诊断价值。方法对517例患者的517个实性结节,先进行二维超声检查,观察结节的形态、边缘、内部回声、有无钙化、周边有无晕环及晕环的完整性等,在进行彩色血流信号观察结节的血流情况,最后启动弹性成像技术:声触诊组织量化(VTQ)、弹性超声成像(EI)技术。结果 EI将弹性图分成6级,了解组织的相对硬度,恶性结节96个,良性结节421个,声触诊组织量化值,VTQ值≥3.1 m/s的结节125个,VTQ值<3.1 m/s的结节392个,将诊断结果与术后病理结果对照分析,联合诊断甲状腺恶性结节的敏感度、特异度、准确度分别为83.3%、97.4%、94.4%。UE、EI、VTQ的联合诊断甲状腺结节的良恶性检出率差异具有统计学意义(P<0.05)。结论二维超声、实时弹性成像、声触诊组织量化三者技术的联合应用,能较客观评价甲状腺结节的相对硬度,有助于甲状腺良恶性结节的鉴别,同时也弥补了以往二维超声诊断的不足。随着影像学的发展,实时弹性成像、声触诊组织量化技术在超声诊断中必将有着光辉的前景。
Objective To investigate the value of ultrasound real-time elastography (UE) and tissue quantification of acoustic palpation for differential diagnosis of benign and malignant thyroid nodules. Methods 517 solid nodules of 517 patients were examined by two-dimensional ultrasonography, and the morphology, margins, internal echo, calcification, peripheral halo, and halo integrity of the nodules were observed. The color blood flow signal was used to observe the blood flow of the nodule. Finally, the elastic imaging technique was initiated: VTQ and EI technique. Results EI divided the elastogram into 6 levels to understand the relative hardness of the tissue, 96 malignant nodules, 421 benign nodules, tissue quantification values of acoustic palpation, 125 nodules with VTQ values ≥ 3.1 m/s, and VTQ values < There were 392 nodules at 3.1 m/s. The diagnostic results were compared with postoperative pathological findings. The sensitivity, specificity, and accuracy of the combined diagnosis of malignant thyroid nodules were 83.3%, 97.4%, and 94.4%, respectively. The combined detection rate of benign and malignant thyroid nodules by UE, EI, and VTQ was statistically significant (P<0.05). Conclusion The combined use of two-dimensional ultrasound, real-time elastography, and tissue quantification for acoustic palpation can objectively evaluate the relative hardness of thyroid nodules and help differentiate the benign and malignant thyroid nodules. The lack of ultrasound diagnosis. With the development of imaging, real-time elastography and acoustic palpation tissue quantification technology will surely have brilliant prospects in ultrasound diagnosis.