Study on the multi-parameter differences of benign and malignant thyroid nodules by ultrasound elastography
超声弹性成像对甲状腺结节良恶性多参数差异研究

摘要

目的 探讨超声弹性成像多参数在甲状腺结节良恶性鉴别中的应用价值及诊断效能。方法 选取2021年1月至2025年1月收治的200例甲状腺结节患者，术后病理结果作为金标准，分良性组与恶性组。术前行超声弹性成像检查，记录Emean、Emax、Eratio、SWV等参数，评估常规超声特征。采用t检验、χ²检验及多因素Logistic回归分析，绘制ROC曲线评价诊断效能。结果 恶性组Emean、Emax、Eratio、SWV及弹性评分均显著高于良性组（P<0.001）。微钙化、边界不清、纵横比≥1等常规特征具有统计学差异。Emax和Eratio为独立预测因子，联合模型AUC达0.938，显著优于单项参数。结论 超声弹性成像多参数能有效区分甲状腺结节良恶性，联合分析可显著提高诊断准确性，具有较高临床应用价值。

Abstract

Objective To explore the application value and diagnostic efficacy of multi-parameter ultrasound elastography in the differentiation of benign and malignant thyroid nodules.
Methods Two hundred patients with thyroid nodules admitted from January 2021 to January 2025 were selected. The postoperative pathological results were used as the gold standard and they were divided into the benign group and the malignant group. Ultrasound elastography was performed before the operation to record parameters such as Emean, Emax, Eratio, and SWV, and to evaluate conventional ultrasound features. T-test, χ² test and multivariate Logistic regression analysis were used to draw the ROC curve to evaluate the diagnostic efficacy.
Results The Emean, Emax, Eratio, SWV and elasticity scores in the malignant group were significantly higher than those in the benign group (P<0.001). The conventional features such as microcalcification, unclear boundaries, and aspect ratio ≥1 showed statistically significant differences. Emax and Eratio are independent predictors. The AUC of the combined model reaches 0.938, which is significantly better than that of a single parameter.
Conclusion   Multi-parameter ultrasound elastography can effectively distinguish between benign and malignant thyroid nodules. Combined analysis can significantly improve diagnostic accuracy and has high clinical application value.