目的比较超声引导下细针穿刺 细胞学、弹性成像及MRI诊断甲状腺癌的 临床价值。方法 回顾性分析我院2016年1 月-2018年1月收治的120例甲状腺结节患 者的临床资料，所有患者均行手术切除， 共135个甲状腺结节，且所有患者术前均 经超声弹性成像、超声引导下细针穿刺细 胞学以及MRI检查，依据结节大小分为A组 (结节>1cm)和B组(结节≤1cm)，并以手术 结果为金标准，将上述检查结果与之进行 对比研究，以分析其诊断甲状腺癌的准确 性和灵敏度、特异性、准确性、阳(阴)性 预测值以及Kappa值(一致性)。结果 超声 引导下细针穿刺细胞活检诊断甲状腺癌的 灵敏度为0.917，特异度为0.846，准确度 为0.904，阳性预测值为0.962，阴性预测 值为0.710；超声弹性成像诊断甲状腺癌 的灵敏度为0.927，特异度为0.885，准确 度为0.919，阳性预测值为0.971，阴性预 测值为0.742；MRI诊断甲状腺癌的灵敏 度为0.908，特异度为0.769，准确度为 0.881，阳性预测值为0.943，阴性预测值 为0.667；A组三种诊断方法的灵敏度均高 于B组。结论 超声引导下细针穿刺细胞 学、弹性成像及MRI对于甲状腺癌均具有 一定临床诊断价值，且病灶越大，越利于 检出。

Objective To compare the clinical value of ultrasound-guided fine needle aspiration cytology, elastography and MRI in the diagnosis of thyroid cancer. Methods The clinical data of 120 patients with thyroid nodules admitted to our hospital from January 2016 to February 2018 in our hospital were analyzed retrospectively. All patients were given surgical resection, a total of 135 thyroid nodules, and all patients were examined by ultrasonic elastography, ultrasound-guided fine needle aspiration cytology and MRI. According to the nodules size, they were divided into group A (nodule > 1cm) and group B (nodule ≤ 1cm). The surgical results were taken as the gold standard to compare and study the above test results, and the accuracy and sensitivity, specificity, accuracy, positive (negative) predictive value, and Kappa value (consistency) of thyroid cancer were analyzed. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasound-guided fine needle aspiration biopsy in the thyroid cancer diagnosis were 0.917, 0.846, 0.904, 0.962 and 0.710. The sensitivity specificity, accuracy, positive predictive value and negative predictive value of ultrasonic elastography for thyroid cancer diagnosis were 0.927, 0.885, 0.919, 0.971 and 0.742. The sensitivity specificity, accuracy, positive predictive value and negative predictive value of MRI for thyroid cancer diagnosis were 0.908, 0.769, 0.881, 0.943 and 0.667. The sensitivity of the three diagnostic methods in group A was higher than that in group B. Conclusion Ultrasound-guided fine needle aspiration cytology, elastography and MRI have certain clinical diagnostic value for thyroid cancer, and the larger the thyroid gland, the better it is detected.