声辐射力脉冲成像技术在甲状腺结节中的诊断价值
发布时间：2018-09-09 12:15
【摘要】：目的 声触诊组织定量(VTQ)技术是声辐射力脉冲成像技术(ARFI)新的测量组织硬度的一种定量技术，探究它对甲状腺良恶性结节鉴别诊断的价值并把它与二维超声成像相比较。 资料与方法 本研究包括128例患者136个结节，均经病理证实，且所有结节都首先行常规超声检查，然后行ARFI的VTQ技术检查。记录每一个结节二维超声特征，再将VTQ技术检查的组织硬度以剪切波速度(SWV)和剪切波速度比值(SWR)记录下来。受试者操作特性曲线(ROC)分析用来评价二维超声及SWV和SWR在良恶性结节之间的鉴别诊断。二维超声和VTQ技术ROC曲线下的面积被计算，它们之间的面积比较用Z检验，p0.05为差异有统计学意义。 结果 1.102个良性结节中，14(13.7%)个病灶周边有声晕；41(40%)个病灶有微钙化；97(95.1%)个病灶呈低回声；7(6.8%)个病灶纵横比1；37(36.2%)个病灶内部有血流信号。32个恶性结节中，3(8.8%)个病灶周边有声晕；12(35.4%)个病灶有微钙化；33(97.9%)个病灶呈低回声；19(55.8%)个病灶纵横比1；21(61.7%)个病灶内部有血流信号。 根据超声各评分诊断点作为检验变量，以病理诊断为状态变量，作ROC曲线，诊断甲状腺良、恶性结节的曲线下的面积为0.725，诊断临界点≥4分，二维超声诊断良恶性结节的ROC曲线下面积最大(0.716)，约登指数为：0.441，其敏感性、特异性分别为62.8%、81.3%。 2.甲状腺良、恶性结节的SWV分别为：(2.37±0.38)m/s、(3.93±1.96) m/s(t=4.907，p值=0.000)；甲状腺良、恶性病灶SWR分别为：1.15±0.28、1.77±0.69(t=4.512，p值=0.000)；SWV大于2.75m/s作为诊断甲状腺结节敏感性81.4%，特异性82.1%，准确性80.8%，，阳性预测值58.6%,阴性预测值92.2%；SWR大于1.32诊断甲状腺结节的敏感性69.8%，特异性89.3%，准确性83.8%，阳性预测值67.6%,阴性预测值89.2%，SWV的ROC曲线下的面积0.868(95%CI:0.762,0.941)(p=0.000)和SWR的ROC曲线下的面积0.813(95%CI:0.687,0.901)(p=0.000)之间无统计学差异(p0.20)。 3.把各个SWV作为检验变量，以病理诊断为状态变量制作ROC曲线，ROC曲线下的面积为0.868，p值0.000，标准误0.040；把超声各评分诊断点作为检验变量，以病理诊断为状态变量制作ROC曲线，ROC曲线下的面积为:0.725，p值0.001，标准误0.045；两者经Z检验，Z=2.897，p0.004，两者比较差异有统计学意义。 结论 ARFI的VTQ成像对组织的硬度提供一种量化和可重复的信息，在鉴别甲状腺良恶性结节方面是一种有用的技术，VTQ的诊断准确性高于二维超声，被认为是常规超声成像的一个有益补充。
[Abstract]:Objective the technique of acoustic palpation tissue quantitative (VTQ) (VTQ) is a new quantitative technique for measuring tissue hardness by acoustic radiation pulse imaging (ARFI). To explore its value in differential diagnosis of benign and malignant thyroid nodules and compare it with two-dimensional ultrasound imaging. Materials and methods this study included 136 nodules in 128 patients, all of which were confirmed by pathology, and all nodules were examined by conventional ultrasound first, then by VTQ technique of ARFI. The two-dimensional ultrasonic characteristics of each node were recorded and the tissue hardness measured by VTQ technique was recorded with shear wave velocity (SWV) and shear wave velocity ratio (SWR). (ROC) analysis was used to evaluate the differential diagnosis between benign and malignant nodules by two dimensional ultrasound, SWV and SWR. The area under the ROC curve of two-dimensional ultrasound and VTQ technique was calculated and the difference between them was statistically significant by Z test. Results 1.14 (13.7%) of 102 benign nodules had microcalcification around 41 (40%) lesions, 97 (95.1%) had hypoechoic lesions and 7 (6.8%) had a aspect ratio of 1. In 37 (36.2%) lesions, there was blood flow signal in 37 (36.2%) lesions, and in 3 (8.8%) of 32 malignant nodules, 12 (35.4%) lesions had microcalcification. 33 (97.9%) lesions showed hypoechoic lesions. The aspect ratio of 19 (55.8%) lesions to 121 (61.7%) lesions had blood flow signals. According to the diagnostic points of ultrasound scores as test variables and pathological diagnosis as state variables, the ROC curve was used to diagnose benign and malignant thyroid nodules. The area under the curve was 0.725, and the critical point of diagnosis was 鈮
本文编号：2232339
[Abstract]:Objective the technique of acoustic palpation tissue quantitative (VTQ) (VTQ) is a new quantitative technique for measuring tissue hardness by acoustic radiation pulse imaging (ARFI). To explore its value in differential diagnosis of benign and malignant thyroid nodules and compare it with two-dimensional ultrasound imaging. Materials and methods this study included 136 nodules in 128 patients, all of which were confirmed by pathology, and all nodules were examined by conventional ultrasound first, then by VTQ technique of ARFI. The two-dimensional ultrasonic characteristics of each node were recorded and the tissue hardness measured by VTQ technique was recorded with shear wave velocity (SWV) and shear wave velocity ratio (SWR). (ROC) analysis was used to evaluate the differential diagnosis between benign and malignant nodules by two dimensional ultrasound, SWV and SWR. The area under the ROC curve of two-dimensional ultrasound and VTQ technique was calculated and the difference between them was statistically significant by Z test. Results 1.14 (13.7%) of 102 benign nodules had microcalcification around 41 (40%) lesions, 97 (95.1%) had hypoechoic lesions and 7 (6.8%) had a aspect ratio of 1. In 37 (36.2%) lesions, there was blood flow signal in 37 (36.2%) lesions, and in 3 (8.8%) of 32 malignant nodules, 12 (35.4%) lesions had microcalcification. 33 (97.9%) lesions showed hypoechoic lesions. The aspect ratio of 19 (55.8%) lesions to 121 (61.7%) lesions had blood flow signals. According to the diagnostic points of ultrasound scores as test variables and pathological diagnosis as state variables, the ROC curve was used to diagnose benign and malignant thyroid nodules. The area under the curve was 0.725, and the critical point of diagnosis was 鈮
本文编号：2232339
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