超声弹性成像及 CT 检查对术前甲状腺肿物性质判断的相关性研究

摘要

Objective: To compare the clinical and pathological relationship between the preoperative ultrasonographic elastography and CT examination and postoperative pathologic results of thyroid carcinoma . Methods:62 cases of postoperative pathologic and totally 75 clinical data of thyroid nodule of ultrasonographic elasticity imaging examination , CT findings with clinical and pathological data were analysised retrospectively in our hospital between 2012.9 and 2013.6.According to the results of ultrasonographic elasticity classification and CT results, the character of thyroid neoplasm was preliminarily judged , and in addition , intraoperative observation of the nodule characteristics and postoperative pathological results were retrospectively analyzed .Results: It was 36 .67% of misdiagnosis rate of ultrasonographic elasticity imaging in judging benign nodule , 15 .56% of misdiagnosis rate in judging malignant nodules , and total misdiagnosis rate was 24.0%.However, It was 57.14%of misdiagnosis rate of CT examination in judging thyroid nodule , and the total misdiagnosis rate was more than 50% in judging tiny papillary carcinoma .Conclusion:Ultrasonographic elasticity imaging have high sensitivity and specificity degrees in judgement of malignant tumor , especially in tiny papillary carcinoma , which is significantly higher than that of CT examination .For thyroid nodules , in order to increase the accurate rate of diagnosis , ultrasonographic elastography can be used as routine examination of thyroid nodules .%目的：探讨术前超声弹性成像及CT检查对甲状腺肿物性质判断与甲状腺术后病理结果的相关性。方法：收集2012年9月至2013年6月江苏省肿瘤医院住院并行术后病理学检查的62例患者共75枚甲状腺结节的临床数据，分别对甲状腺超声弹性成像、CT检查结果及术后病理结果进行总结分析，根据超声弹性分级及CT结果初步判断甲状腺肿物的性质，并与术中对结节性状的观察及术后的病理结果进行对比分析。结果：75枚甲状腺结节中，良性30枚，恶性45枚，超声弹性成像判断良性结节误诊率为36．67％，判断恶性结节误诊率15．56％，总误诊率24．0％。 CT检查中有12枚结节判断错误，误诊率为57．14％，对于微小乳头状癌判断误诊率大于50％。结论：超声弹性成像对判断甲状腺良恶性结节具有较高的敏感度和特异度，对恶性肿瘤的判断，特别是对甲状腺微小癌判断的准确率要明显高于CT检查，甲状腺肿物超声弹性成像可作为甲状腺术前的常规检查。