[关键词]
[摘要]
目的:探讨甲状腺微小癌的声像图表现及弹性成像定量参数分析在甲状腺微小癌的超声诊断价值。
方法:经术后病理证实的126 例( 138 个病灶) 甲状腺实性结节病人，回顾性分析病灶的形态特征、彩色多普勒显
像及弹性应变率比值测定。根据结节良恶性分为两组，比较组间弹性应变率比值。结果: 甲状腺微小癌声像图
表现大多外形规则，多为低回声，边界欠清，纵横比＞ 1。少部分伴有微小钙化，极少有声晕。良性组结节与甲状
腺微小癌弹性应变率比值两组间差异有显著性意义( P ＜ 0． 05) 。通过ROC 曲线分析取得最合适诊断临界点为
2． 50，即Ratio≥2． 50者诊断为恶性，Ratio ＜ 2． 50为良性。以病理结果为金标准，弹性成像诊断甲状腺微小癌的
灵敏度90． 32%、特异性96． 05%、精确性93． 48%。结论:甲状腺微小癌声像图表现与以往研究结果不尽相同; 实
时超声弹性成像定量分析为甲状腺微小癌的诊断提供了一种新的方法，能较客观的反映病灶的硬度，可提高超
声诊断的准确率。
[Key word]
[Abstract]
Objective: Explore ultrasonographic manifestation of thyroid micro － carcinoma and
elastosonography quantitative parameters analysis on the value of ultrasonic diagnosis of thyroid micro －
carcinoma． Methods: Confirmed by postoperative pathology in 126 cases( 138 lesions) of patients with
thyroid solid nodules， retrospectively annals the morphological characteristics of lesions，color Doppler
flow imaging and determination of the elastic strain rate ratio． According to the benign and malignant
nodules can be divided into two groups， the elastic strain rate ratio between comparison groups． Results:
Ultrasonographic manifestation of thyroid micro － carcinoma mostly appearance rules，more for low
echo， less clear boundaries，aspect ratio ＞ 1． With a few small calcification， rarely recorded halo． The elastic
strain rate ratio of benign nodules and thyroid micro － carcinoma were significant differences be-
tween the two groups( P ＜ 0． 05) ． Using ROC curve analysis to obtain the most appropriate diagnostic
point is 2． 50，namely Ratio≥2． 50 diagnosed as malignant，Ratio ＜ 2． 50 for benign． With pathologic
results as the gold standard， the elastosonography diagnosis of thyroid micro － carcinoma has 90． 32%
for sensitivity， specificity of 96． 05% and accuracy of 93． 48%． Conclusion: The ultrasonographic manifestations
of thyroid micro － carcinoma is not the same with the previous research results; Real － time
ultrasound elastosonography quantitative parameters analysis for the diagnosis of thyroid micro － carcinoma
provides a new approach that can objectively reflect the lesions of hardness，can improve the accuracy
of ultrasonic diagnosis．
[中图分类号]
R445． 1
[基金项目]
收稿日期: 2013 － 11 － 13; 修回日期: 2014 － 01 － 08
基金项目: 内蒙古医科大学百万基金项目( 2013KJBW007)
作者简介: 张英霞( 1971 － ) ，女，内蒙古医科大学附属医院超声科主任医师，硕士研究生导师。
通讯作者: 武仁，主任医师，E － mail: WuＲen1126@ sina． cn 内蒙古医科大学附属医院超声科， 010050
