目的 探讨18氟-氟代脱氧葡萄 糖(18F-FDG)正电子发射计算机断层扫描 (PET/CT)联合剪切波弹性成像(SWE)对 良、恶性甲状腺结节诊断的价值。方法 回顾性分析2016年1月-2018年1月我院收 治的87例甲状腺结节患者的临床资料。所 有患者均经病理检查确诊，入院后均行 18F-FDG PET/CT和SWE两种影像学检查。以 病理检查结果为“金标准”，评估两种检 查方法及联合检查对良恶性甲状腺结节的 诊断价值。结果 共87例患者114个甲状腺 结节中，恶性结节81个(71.05%)，良性结 节33个(28.95%)；18F-FDG PET/CT检查的 诊断灵敏度、特异度、准确率、阳性预测 值、阴性预测值分别为80.25%(65/81)、 66.67%(22/33)、76.32%(87/114)、 85.53%(65/76)、57.89%(22/38)， SWE检查分别为85.19%(69/81)、 72.73%(24/33)、81.58%(93/114)、 88.46%(69/78)、66.67%(24/36)，两 者联合检查分别为91.36%(74/81)、 84.85%(28/33)、89.47%(102/114)、 93.67%(74/79)、80.00%(28/35)；3种检 查方法的诊断灵敏度、特异度、阳性预测 值、阴性预测值比较，差异均无统计学意 义(P﹥0.05)，但与单一检查比较，联合检 查上述指标有较大幅度提升，而准确率 比较，联合检查﹥SWE﹥18F-FDG PET/CT(P﹤ 0.05)。结论 18F-FDG PET/CT和SWE两种影 像学检查对良恶性甲状腺结节均有较高的 诊断价值，各有优势，两者联合应用可明 显提高诊断准确性。

Objective To explore the value of 18F-fluorodexyglucose (18F-FDG) positron emission computed tomography (PET/CT) combined with shear wave elastography (SWE) in the diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 87 patients with thyroid nodules admitted to our hospital between January 2016 and January 2018 were analyzed retrospectively. All patients were diagnosed by pathological examination, and were given 18F-FDG PET/CT and SWE after admission. The results of pathological examination were taken as "gold standard" to evaluate the diagnostic value of two methods and combined examination in the diagnosis of benign and malignant thyroid nodules. Results Of the 87 patients with 114 thyroid nodules, 81 cases (71.05%) were malignant nodules and 33 cases (28.95%) were benign nodules. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 80.25% (65/81), 66.67% (22/33), 76.32% (87/114), 85.53% (65/76) and 57.89% (22/38) respectively by 18F-FDG PET/CT, and were 85.19% (69/81), 72.73% (24/33), 81.58% (93/114), 88.46% (69/78) and 66.67% (24/36) by SWE check, and were 91.36% (74/81), 84.85% (28/33), 89.47% (102/114), 93.67% (74/79) and 80.00% (28/35) by the combined examination. There was no significant difference in the diagnostic sensitivity, specificity, positive predictive value and negative predictive value among the three examination methods (P>0.05), but compared with single examination, the above indicators by combined examination were significantly increased, and the accuracy rate showed combined inspection>SWE>18F-FDG PET/CT. (P<0.05). Conclusion Both 18F-FDG PET/CT and SWE have high diagnostic value for benign and malignant thyroid nodules, and each has its own advantages. The combination of the two can improve the diagnostic accuracy significantly.