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目的:探讨剪切波弹性成像(SWE)诊断结果为假阴性和假阳性甲状腺结节的二维超声及SWE特点,以提高诊断准确率。方法:选择我院就诊的189例甲状腺结节患者,共189个结节,均经手术及病理证实。记录每例患者结节的二维超声成像特点、SWE特点及术后病理结果,比较分析SWE检测为假性和真性结节的二维成像特点。结果:术后病理显示189个结节中,良性结节74个(39.2%),恶性结节115个(60.8%)。常规超声诊断甲状腺恶性结节的敏感性为56.5%、特异性为81.1%;SWE诊断甲状腺恶性结节的敏感性为60.9%、特异性为85.1%。SWE诊断良性结节的假阳性率和恶性结节的假阴性率分别为14.9%和39.1%,假阴性率高于假阳性率。纵横比>1和直径偏小(<0.5cm)均与SWE的误诊显著相关(P<0.01)。结论:SWE在鉴别甲状腺结节的良恶性中具有重要意义,但也存在漏诊或误诊,临床医生基于SWE作出诊断时,应仔细评估其二维超声特点及其他检查结果。
Objective: To investigate the characteristics of shear wave elastography (SWE) diagnosis of false-negative and false-positive thyroid nodules by two-dimensional ultrasound and SWE features to improve the diagnostic accuracy. Methods: A total of 189 nodules were selected from 189 thyroid nodules in our hospital, which were confirmed by operation and pathology. Two-dimensional ultrasound imaging characteristics, SWE characteristics and postoperative pathological findings of each patient’s nodules were recorded. The two-dimensional imaging features of the false and true nodules were compared and analyzed. Results: Postoperative pathology showed that in 189 nodules, there were 74 benign nodules (39.2%) and 115 malignant nodules (60.8%). The sensitivity and specificity of conventional sonography in diagnosing malignant thyroid nodules were 56.5% and 81.1% respectively. The sensitivity and specificity of SWE in diagnosing thyroid malignant nodules were 60.9% and 85.1% respectively. The false-negative rate of SWE in diagnosing benign nodules and that of malignant nodules were 14.9% and 39.1% respectively, and the false-negative rate was higher than that of false-positive rate. Aspect ratio> 1 and small diameter (<0.5cm) were significantly associated with misdiagnosis of SWE (P <0.01). Conclusion: SWE plays an important role in the differential diagnosis of benign and malignant thyroid nodules, but there is also misdiagnosis or misdiagnosis. When the clinicians make the diagnosis based on SWE, the characteristics of two-dimensional ultrasound and other examinations should be carefully evaluated.