[1]沈冬花,李 蓉,周玲莉,等.实时剪切波弹性成像超声检查在甲状腺良恶性结节鉴别诊断中的应用[J].陕西医学杂志,2021,50(8):999-1002.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.024]
　SHEN Donghua,LI Rong,ZHOU Lingli,et al.Application of real-time shear wave elastography in differential diagnosis of benign and malignant thyroid nodules[J].,2021,50(8):999-1002.[doi:DOI:10.3969/j.issn.1000-7377.2021.08.024]
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实时剪切波弹性成像超声检查在甲状腺良恶性结节鉴别诊断中的应用
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年8期
页码:
999-1002
栏目:
临床研究
出版日期:
2021-08-05

文章信息/Info

Title:
Application of real-time shear wave elastography in differential diagnosis of benign and malignant thyroid nodules
作者:
沈冬花1; 李 蓉1; 周玲莉2; 杨金君3; 冀 波1; 王 龚1
(1.解放军火箭军特色医学中心超声诊断科,北京 100088; 2.解放军联勤保障部队第九二二医院超声诊断科,湖南 衡阳 421001; 3.咸阳市第一人民医院超声医学科,陕西 咸阳 712000)
Author(s):
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)
关键词:
甲状腺结节;  诊断;  TI-RADS分级;  实时剪切波弹性成像超声;  杨氏模量值;  病理特征
Keywords:
Thyroid nodules;  Diagnosis;  TI-RADS classification;  Real-time shear wave elastography;  Young's modulus value;  Pathological characteristics
分类号:
R 445.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.08.024
文献标志码:
A
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Emax、Emin和Emean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Emean均高于无钙化患者(P<0.05),病灶位置、是否囊性病变对Emean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Emean值无明显影响(均P>0.05); ROC曲线分析结果显示,Emax、Emin和Emean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Emax、Emin和Emean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。
Abstract:
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 Emax,Emin and Emean 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,Emean 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 Emean(all P>0.05).In the malignant group,lesion location,whether cystic lesions and calcification condition had no significant effect on Emean(all P>0.05).ROC curve analysis showed that the area under the ROC curve(AUC)values of Emax,Emin,Emean 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 Emax,Emin and Emean 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.

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备注/Memo

备注/Memo:
基金项目:北京市科技计划项目(2018AD31106)
更新日期/Last Update: 2021-08-05