摘要: |
目的 探讨常规超声联合超声造影(CEUS)诊断甲状腺结节的价值,分析联合诊断中误诊结节的特征及原因。方法 回顾性分析有病理证实的522例甲状腺结节患者常规超声及CEUS资料,比较常规超声及联合CEUS对甲状腺良恶性结节的诊断效能,分析联合诊断误诊的53例结节常规超声及CEUS特征并探讨误诊原因。结果 常规超声联合CEUS诊断甲状腺良恶性结节的特异度、敏感度、准确度分别为87.1%、94.1%、89.8%,高于常规超声的81.2%、84.7%、82.5%,差异均有统计学意义(P均<0.05)。联合诊断中(41/53)例良性结节误诊恶性,(12/53)例恶性结节误诊良性,误诊的良性结节均包含≥2个以下特征:低回声?纵横比≥1?边界不清?形态不规则?包膜侵犯?微钙化等,误诊的恶性结节表现出等增强、高增强等CEUS特征。结论 常规超声联合CEUS可提高对甲状腺结节的诊断价值,但良恶性结节在常规超声及CEUS特征上均有一定程度的交叉重叠,可导致误诊。 |
关键词: 甲状腺结节,常规超声,超声造影,误诊 |
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基金项目:广西卫计委自筹课题(编号:Z20180744),广西卫计委自筹课题(编号:Z20210677) |
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Diagnostic value and misdiagnosis of thyroid nodules by conventional ultrasound combined with contrast-enhanced ultrasound |
韦柳1,2,3
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1.People'2.'3.s Hospital of Guangxi Zhuang Autonomous Region
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Abstract: |
0bjective To evaluate the value of conventional ultrasound combined with contrast-enhanced ultrasound(CEUS) in the diagnosis of thyroid nodul,and analyze the characteristics and causes of misdiagnosis of nodules in combined diagnosis. Methhods Conventional ultrasound and CEUS data of 522 patients with thyroid nodules confirmed by pathology were retrospectively analyzed,to compare the diagnostic efficacy of conventional ultrasound combined with CEUS in benign and malignant thyroid nodules,and the features of conventional ultrasound combined with CEUS in 53 cases of nodules misdiagnosed in combined diagnosis were analyzed and the causes of misdiagnosis were discussed. Results The specificity,sensitivityand accuracy of conventional ultrasound combined with CEUS were 87.1%、94.1%、89.8%,which were higher than 81.2%、84.7%、82.5% of conventional ultrasound . The difference was of statistical significance (all P<0.05). In 53 cases of misdiagnosis, 41 cases of benign nodules were misdiagnosed as malignant nodules and 12 cases of malignant nodules were misdiagnosed as benign nodules. All misdiagnosed benign nodules had equal or more than two of the following characteristics: low level echo、aspect ratio≥1、obscure boundary、irregularSin shape、capsular invasion、microcalcification and so on,the misdiagnosed malignant nodules showed CEUS features of isoenhancement and hyperenhancement. Conclusion Conventional ultrasound combined with CEUS can improve the diagnostic value of thyroid nodules,however benign and malignant nodules overlap in conventional ultrasound and CEUS characteristics to a certain extent, which often leads to misdiagnosis. |
Key words: Thyroid nodule, Conventional ultrasound,CEUS, Misdiagnosis |