实时剪切波弹性成像对甲状腺结节良恶性的诊断及影响因素分析

发布时间：2018-05-17 08:01

本文选题：弹性成像技术 + 剪切波弹性成像　；参考：《中国医学影像技术》2015年12期

【摘要】：目的探讨剪切波弹性成像(SWE)各参数对甲状腺结节良恶性鉴别诊断的临床价值。方法应用SWE对拟接受手术或活检的221例甲状腺结节患者(265个结节)进行检查,测量结节的绝对弹性值。以病理结果为金标准,绘制ROC曲线,得到最优的诊断界点,并以此进行良恶性诊断。根据ROC曲线下面积评价各个SWE参数的诊断价值。同时,分析可能存在的影响因素。结果 265个甲状腺结节中,良性177个,恶性88个。恶性结节的杨氏模量均高于良性结节,差异有统计学意义(P均0.05)。5个SWE参数(SWE_whole_mean、SWE_whole_min、SWE_mean、SWE_min、SWE_max)诊断结节良恶性的ROC曲线下面积分别为0.793、0.656、0.801、0.796和0.791。SWE_mean的ROC曲线下面积(AUC)面积最大,以最优的诊断界点为39.2 kPa进行良恶性诊断,诊断的敏感度和特异度分别为67.05%和83.62%。各可能的影响因素中,结节内钙化会使测量到的杨氏模量值增加。SWE与常规超声联合应用的诊断敏感度为86.36%。结论 SWE有助于甲状腺结节良恶性的鉴别诊断。
[Abstract]:Objective to evaluate the clinical value of shear wave elastic imaging (SWE) parameters in the differential diagnosis of benign and malignant thyroid nodules. Methods SWE was used to examine 221 patients with thyroid nodules (265 nodule), and the absolute elasticity of thyroid nodules was measured. According to the gold standard of pathological results, the ROC curve was drawn to obtain the optimal diagnostic boundary point, and then the benign and malignant diagnosis was carried out. The diagnostic value of each SWE parameter was evaluated according to the area under the ROC curve. At the same time, the possible influencing factors are analyzed. Results of 265 thyroid nodules, 177 were benign and 88 malignant. The Young's modulus of malignant nodules was higher than that of benign nodules, and the difference was statistically significant (P < 0.05). 5 SWE parameters and whole SWE parameters were compared. The area under the ROC curve for diagnosis of benign and malignant nodules was 0.7930.6560.8010.796 and the area under ROC curve of 0.791.SWE_mean was the largest, respectively. The sensitivity and specificity of diagnosis were 67.05% and 83.62%, respectively. Among the possible factors, calcification in nodules increased the measured Young's modulus. SWE combined with conventional ultrasound had a diagnostic sensitivity of 86.36. Conclusion SWE is helpful in the differential diagnosis of benign and malignant thyroid nodules.
【作者单位】：中山大学附属第一医院超声波科超声诊断与介入超声研究所;
【分类号】：R445.1;R736.1

【共引文献】