摘要
目的:分析探讨声触诊组织量化(virtual touch tissue quantification,VTQ)技术结合常规超声能否提高桥本甲状腺炎背景下甲状腺良恶性结节的检出率,并为后续是否行穿刺病理学检查及治疗方式选择提供有价值的诊断思路。方法:回顾性分析49例桥本甲状腺炎患者的68个结节,常规超声观察甲状腺内部回声及血供情况,通过观察甲状腺结节超声图像的特点,从结节的形态、数目、部位、大小、纵横比、边界、声晕、内部回声及钙化情况、后方回声有无衰减、血供情况及颈部有无异常肿大淋巴结等方面分析,利用VTQ技术对结节进行剪切波速度(shear wave velocity,SWV)测定,并结合常规超声结果与病理结果进行对照分析。结果:68个结节均经病理证实。与病理结果对照,常规超声对良恶性结节的诊断灵敏度为70.59%,特异度为78.43%,约登指数为0.49;VTQ技术判断良恶性结节的灵敏度与特异度均为82.35%,约登指数为0.65;VTQ技术结合常规超声判断良恶性结节的灵敏度为70.59%,特异度为96.08%,约登指数为0.67。结论:VTQ技术结合常规超声可提高桥本甲状腺炎背景下良恶性结节的检出率。对于常规超声诊断为良性结节而VTQ技术考虑为恶性结节者,需行穿刺病理诊断,既能减少恶性结节的漏诊,又能避免良性结节不必要的手术治疗,从而为临床提供有价值的诊断思路。
Objective： To discuss the value of virtual touch tissue quantification（VTQ） technique combined with conventional ultrasonography in detection of benign and malignant thyroid nodules in the background of Hashimoto＇s thyroiditis, and to provide valuable diagnostic ideas for the selection of pathological examination and treatment methods. Methods： Retrospective analysis of 49 cases of Hashimoto＇s thyroiditis with 68 nodules was conducted. The location, size, number, aspect ratio, shape, boundary, acoustic halo, internal echo and calcification, rear echo attenuation, blood supply and abnormal lymph nodes of the thyroid nodules were observed. VTQ technique was used to measure the shear wave velocity（SWV） of thyroid nodules. Results： All the 68 nodules in 49 cases of Hashimoto＇s thyroiditis were pathologically confirmed. Compared with the pathological results, the diagnostic sensitivity of conventional ultrasonography was 70.59%, the specificity was 78.43%, and the Youden＇s index was 0.49. Both the sensitivity and specificity of VTQ technique were 82.35%, and the Youden＇s index was 0.65. The diagnostic sensitivity of VTQ technique combined with conventional ultrasonography was 70.59%, the specificity was 96.08%, and the Youden＇s index was 0.67. Conclusion： VTQ technique combined with conventional ultrasonography can improve the detective rate of benign and malignant nodules in the background of Hashimoto＇s thyroiditis, reduce the missed diagnosis of malignant nodules and avoid unnecessary surgical treatment.
作者
蔡丽萍
王琳
孙燕双
CAI Liping;WANG Ling;SUN Yanshuang(Department of Ultrasound, The 82th Hospital of PLA, Huai’an 223001, Jiangsu Province, China)
出处
《肿瘤影像学》
2017年第5期363-366,共4页
Oncoradiology
关键词
桥本甲状腺炎
甲状腺良恶性结节
常规超声检查
声触诊组织量化技术
病理结果
Hashimoto’s thyroiditis
Benign and malignant thyroid nodules
Conventional ultrasonography
Virtual touch tissue quantifcation technique
Pathological result
