摘要
目的:探究实时剪切波弹性成像超声(SWE)在甲状腺良恶性结节鉴别诊断中的应用价值,分析SWE诊断与良恶性结节病理特征间的关系。方法:回顾性分析接受治疗的180例甲状腺良恶性结节患的临床及影像学资料,根据手术病理结果将患者分为良性组(n=107)和恶性组(n=73)。比较两组患者的TI-RADS分级情况和杨氏模量(E)值;分析良恶性结节不同病理特征对E值的影响;受试者工作特征曲线(ROC)评估E值诊断甲状腺良恶性结节的价值。结果:恶性组患者的E max、E min和E mean值均大于良性组(均P<0.05),良性组患者检出3级48例,4a级37例,4b级13例,5级9例,恶性组患者检出3级11例,4a级14例,4b级31例,5级17例,差异有统计学意义(均P<0.05);良性组中,病灶微小钙化、粗大钙化患者的E mean均高于无钙化患者(P<0.05),病灶位置、是否囊性病变对E mean值无明显影响(均P>0.05);恶性组中,病灶位置、是否囊性病变和病灶钙化病况对E mean值无明显影响(均P>0.05);ROC曲线分析结果显示,E max、E min和E mean值及其联合应用的ROC曲线下面积(AUC)分别为0.844、0.794、0.824和0.874,对恶性甲状腺结节的诊断均具有统计学意义(均P<0.001)。结论:SWE技术测定的甲状腺结节E max、E min和E mean值可定量评估结节硬度,在良恶性甲状腺结节的诊断中具有良好的应用价值。
Objective:To explore the application value of real-time shear wave elastography(SWE)in the differential diagnosis of benign and malignant thyroid nodules,and analyze the relationship between SWE diagnosis and pathological characteristics of benign and malignant nodules.Methods:The clinical and imaging data of 180 patients with benign and malignant thyroid nodules were retrospectively analyzed.Tthe patients were divided into benign group(n=107)and malignant group(n=73)according to the surgical and pathological results.TI-RADS classification and Young’s modulus(E)values of the two groups were compared.The influence of different pathological characteristics of benign and malignant nodules on E value was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the value of E value in the diagnosis of benign and malignant thyroid nodules.Results:The E max,E min and E mean of malignant group were higher than those of benign group(all P<0.05).In benign group,there were 48 cases of grade 3,37 cases of grade 4a,13 cases of grade 4b and 9 cases of grade 5,while in the malignant group,there were 11 cases,14 cases,31 cases and 17 cases respectively(all P<0.05).In the benign group,E mean of patients with microcalcification and gross calcification was higher than that of patients without calcification(all P<0.05),and location and whether cystic lesions had no significant effect on E mean(all P>0.05).In the malignant group,lesion location,whether cystic lesions and calcification condition had no significant effect on E mean(all P>0.05).ROC curve analysis showed that the area under the ROC curve(AUC)values of E max,E min,E mean and their combination were 0.844,0.794,0.824 and 0.874 respectively,and the best thresholds were 68.43,35.47 and 62.33 respectively(all P<0.001).Conclusion:The E max,E min and E mean of thyroid nodules measured by SWE can be used to quantitatively evaluate the hardness of nodules,which indicates good clinical application value in the diagnosis of benign and malignant thyroid nodules
作者
沈冬花
李蓉
周玲莉
杨金君
冀波
王龚
SHEN Donghua;LI Rong;ZHOU Lingli;YANG Jinjun;JI Bo;WANG Gong(Department of Ultrasonic Diagnosis,Rocket Force Special Medical Center of the Chinese People’s Liberation Army,Beijing 100088,China)
出处
《陕西医学杂志》
2021年第8期999-1002,共4页
Shaanxi Medical Journal
基金
北京市科技计划项目(2018AD31106)。
