多模态超声技术在甲状腺结节良恶性鉴别诊断中的应用价值OA

Objective To investigate the application value of multimodal ultrasound(mmUS)technique in the differential diagnosis of benign and malignant thyroid nodules.Methods A retrospective analysis was conducted on the medical records of 75 patients with thyroid nodules treated in our hospital from January 2022 to June 2024.The patients were divided into the benign group(46 cases)and the malignant group(29 cases)based on nodule nature.All patients underwent mmUS examination,including grayscale ultrasound,color Doppler flow imaging(CDFI),contrast-enhanced ultrasound(CEUS),and elastography.The grayscale ultrasound features,CDFI blood flow grading and color pixel percentage(CPP)parameters,CEUS features,and shear-wave elastography(SWE)Young's modulus parameters were compared between the two groups.Using pathological results as the"gold standard"for diagnosis,the diagnostic efficacy of single and combined examinations of multimodal ultrasound technology in benign and malignant thyroid nodules was analyzed,and receiver operating characteristic(ROC)curves were drawn to evaluate their application value in benign and malignant thyroid nodules.Results The detection rates of hypoechogenicity,anteroposterior/transverse diameter ratio ≥ 1,and microcalcifications in the malignant group were higher than those in the benign group,while the color blood flow perfusion-related parameter(CDFI-CPP)and shear-wave microvascular perfusion parameter(sUMA-CPP)were lower than those in the benign group,and there was a statistically significant difference in Adler grading between the two groups(P＜0.05).The detection rates of rapid washout,low enhancement level,heterogeneous enhancement,and centripetal enhancement in the malignant group were higher than those in the benign group,and the parameter values within the nodule,as well as at Shell 0.5 mm,Shell 1.0 mm,and Shell 2.0 mm were greater than those in the benign group(P＜0.05).The sensitivity,specificity,and accuracy of the combined examination in diagnosing benign and malignant thyroid nodules were all higher than those of any individual examination.ROC curve analysis showed that the combined examination had high application value in the diagnosis of benign and malignant thyroid nodules,with AUC of 0.912,higher than that of each single examination.Conclusions mmUS technique can significantly improve the differential diagnostic efficacy for benign and malignant thyroid nodules,clearly define nodular ultrasound characteristics,and provide important reference for formulating personalized clinical diagnosis and treatment strategies,which is worthy of clinical promotion and application.