剪切波弹性成像鉴别诊断桥本甲状腺炎合并甲状腺结节的性质

发布时间：2018-11-23 20:56

【摘要】：目的探讨剪切波弹性成像对桥本甲状腺炎患者合并甲状腺结节良恶性的鉴别诊断价值。方法收集经穿刺活检或术后病理证实的桥本甲状腺炎患者54例,根据结节良恶性分为良性结节组和恶性结节组,良性结节组又分为假结节组和真结节组。测量并比较分析甲状腺结节的杨氏模量值,绘制ROC曲线以评价其诊断效能。结果 54例桥本甲状腺炎患者共检出162个结节,其中良性结节131个(真结节93个,假结节38个)、恶性结节31个。桥本甲状腺炎合并良性结节、恶性结节、真结节及假结节的杨氏模量均值分别为(33.04±10.95)kPa、(66.15±19.17)kPa、(35.95±9.74)kPa、(30.13±11.87)kPa。良性结节与恶性结节杨氏模量值差异有统计学意义(t=12.91,P0.01);假结节组、真结节组与恶性结节组的杨氏模量值总体差异有统计学意义(F=36.20,P0.01),且恶性结节组杨氏模量值高于其他2组(P均0.01)。通过ROC曲线确定杨氏模量值的诊断临界点为43.65 kPa,其诊断良恶性甲状腺结节的敏感度为90.63%、特异度为81.25%、阳性似然比为4.83、阴性似然比为0.12。结论剪切波弹性成像技术可以对桥本甲状腺炎及其结节进行定量分析,有助于结节性质的判定。
[Abstract]:Objective to evaluate the value of shear wave elastography in differential diagnosis of benign and malignant thyroid nodules in patients with Hashimoto's thyroiditis. Methods 54 patients with Hashimoto's thyroiditis confirmed by puncture biopsy or postoperative pathology were divided into benign and malignant nodule group and benign nodule group. The benign nodule group was divided into pseudodular group and true nodule group. The Young's modulus of thyroid nodule was measured and analyzed, and the ROC curve was drawn to evaluate its diagnostic efficacy. Results 162 nodules were detected in 54 patients with Hashimoto's thyroiditis, including 131 benign nodules (93 true nodules, 38 pseudonodules) and 31 malignant nodules. The average Young's modulus of Hashimoto's thyroiditis with benign, malignant, true and pseudodular nodules was (33.04 卤10.95) kPa, () 66.15 卤19.17) kPa, (35.95 卤9.74) kPa, (30.13 卤11.87) kPa., respectively. There was significant difference in Young's modulus between benign and malignant nodules (t = 12.91, P0.01). There was significant difference in Young's modulus between pseudodular group, true nodule group and malignant nodule group (F _ (36.20) P _ (0.01), and the Young's modulus value in malignant nodule group was higher than that in other two groups (P < 0.01). The diagnostic critical point of Young's modulus was 43.65 kPa, by ROC curve. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio for benign and malignant thyroid nodules were 90.63, 81.25, 4.83 and 0.12, respectively. Conclusion Shear wave elastography can be used to quantitatively analyze Hashimoto's thyroiditis and its nodules, which is helpful to the determination of nodular properties.
【作者单位】：海南省人民医院超声科;海南省农垦三亚医院超声科;
【基金】：三亚市医疗卫生科技创新项目(2015YW33)
【分类号】：R445.1;R581

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