目的 探讨超声弹性成像联合高频超声在甲状腺乳头状癌诊断中的应用价值。方法 2022年1月—2023年6月选择在中国人民解放军联勤保障部队第九九〇医院诊治的疑似甲状腺乳头状癌患者82例,所有患者均给予超声弹性成像联合高频超声检查,记录超声特征。所有患者均行病理检查,并以病理检查作为判断的金标准。结果 在82例患者中,病理诊断为甲状腺乳头状癌48例（癌性组）,占比58.54%;甲状腺良性结节34例（良性组）,占比41.46%。癌性组的形态异常、后方回声衰减、钙化、晕环征、边界不清晰、内部低回声等超声征象占比为81.25%、83.33%、83.33%、83.33%、81.25%、81.25%,高于良性组的52.94%、47.06%、47.06%、41.18%、47.06%、52.94%（P<0.05）。癌性组的收缩期最高流速低于良性组（P<0.05）,阻力指数、搏动指数与良性组相比有提高（P<0.05）。癌性组的弹性成像评分多为3~4分,良性组多为2分,两组比较差异有统计学意义（P<0.05）。超声弹性成像联合高频超声判断为甲状腺乳头状癌47例,诊断中的灵敏度与特异度分别为97.92%（47/48）和100.00%（34/34）。结论 甲状腺乳头状癌在超声上多表现为血流信号异常、钙化、后方回声衰减、晕环征等特征,超声弹性成像评分多为3~4分,超声弹性成像联合高频超声在其诊断中具有较高的应用价值。

Objective To explore the application value of ultrasound elastography combined with high-frequency ultrasound in the diagnosis of papillary thyroid cancer（PTC）．Methods From January 2022 to June 2023,82 patients with suspected PTC were treated at Chinese People’s Liberation Army Joint Logistics Force 990 Hospital．All patients were given ultrasound elastography combined with high-frequency ultrasound examination to record ultrasound features．All cases were given pathological examination,and the pathological examination were used as the gold standard for diagnosis．Results Among the 82 patients,48 were PTC（cancerous group）,accounting for 58.54%;and the other 34 were benign thyroid nodules（benign group）,accounting for 41.46%．The proportion of morphological abnormalities,posterior echo attenuation,calcification,halo ring signs,unclear boundary and internal hypoechoics in cancerous group were 81.25%,83.33%,83.33%,83.33%,81.25% and 81.25%,which were significantly higher than 52.94%,47.06%,47.06%,41.18%,47.06% and 52.94% in the benign group（P<0.05）．The highest systolic flow velocity in the cancerous group was significantly less than that in the benign group（P<0.05）,and the resistance index and pulse index were also significantly higher compared with the benign group（P<0.05）．The elastography score were mostly 3~4 in the cancerous group and 2 in the benign group,with a significant difference between the two groups（P<0.05）．Forty-seven cases of PTC were diagnosed by ultrasound elastography combined with high frequency ultrasonography,and the sensitivity and specificity in diagnosis were 97.92%（47/48）and 100.00%（34/34）,respectively．Conclusions PTC is often characterized by abnormal blood flow signals,calcification,posterior echo attenuation,halo sign and so on．The ultrasound elastography score is usually 3~4 points．Ultrasonic elastography combined with high frequency ultrasound has high value in diagnosis of PTC．

目的 探讨实时超声弹性成像技术联合常规超声检查在评估脑卒中患者颈动脉粥样硬化斑块稳定性中的临床应用价值。方法 收集我院收治的临床确诊脑卒中患者(卒中组)34例作为研究对象,另抽取同期存在颈动脉斑块但未发生过脑卒中的人群(对照组)56例作为对照研究对象,进行超声弹性成像检测,并对检查结果进行统计分析。结果 34例脑卒中患者发现颈动脉粥样硬化斑块57个,其中低回声斑块29个,混合回声斑块21个,强回声斑块7个;56例对照组患者发现颈动脉粥样硬化斑块75个,其中低回声斑块22个,混合回声斑块25个,强回声斑块28个;两组间比较斑块数量之间、斑块大小之间差异有统计学意义(P<0.05)。颈动脉粥样硬化低回声、混合回声及强回声斑块弹性评分依次升高,其斑块硬度值依次升高;两组间斑块的评分数量分布差异有统计学意义(P<0.05);对于同一类型斑块的硬度值两组间差异无统计学意义(P>0.05);脑卒中组不同类型斑块间的硬度值差异有统计学意义(P<0.05)。结论 超声弹性成像技术可对脑卒中患者颈动脉粥样硬化斑块的稳定性进行半定量评估,不同类型斑块因所含组织成分的不同其弹性应变率表现也不同,能有效补充常规超声检查的信息的不足,进而评估斑块的稳定性。

Objective To explore the clinical value of real-time ultrasound elastography combined with conventional ultrasound in assessing the stability of carotid atherosclerotic plaques in stroke patients. Methods Thirty-four patients with clinically confirmed stroke (stroke group) in our hospital were collected as the research object. Another 56 patients with carotid plaque but without stroke (control group) in the same period were selected as the control object for ultrasonic elastography detection, and the results were analyzed statistically. Results Thirty-four stroke patients were found 57 carotid atherosclerotic plaques, including 29 hypoechoic plaques, 21 mixed echoic plaques and 7 hyperechoic plaques; 56 control patients were found 75 carotid atherosclerotic plaques, including 22 hypoechoic plaques, 25 mixed echoic plaques and 28 hyperechoic plaques. There were significant differences between the number of plaques and the size of plaques (P<0.05). Carotid atherosclerosis low echo, mixed echo and strong echo plaque elasticity score increased in turn, the plaque hardness value increased in turn; the number of plaque scores between the two groups had statistical significance (P<0.05); for the same type of plaque hardness value between the two groups had no significant difference (P>0.05); There were significant differences in hardness values between the same types of plaques (P<0.05). Conclusion Ultrasound elastography may semi-quantitatively evaluate the stability of carotid atherosclerotic plaques in stroke patients. Different types of plaques have different elastic strain rates because of different tissue components. It may effectively complement the information deficiency of conventional ultrasound examination, and then evaluate the stability of plaques.