剪切波弹性成像鉴别甲状腺良恶性结节的诊断价值

发布时间：2018-02-23 23:37

本文关键词： 甲状腺结节弹性成像技术超声检查　出处：《中国全科医学》2017年18期 　论文类型：期刊论文

【摘要】：目的探讨剪切波弹性成像鉴别甲状腺良、恶性结节的诊断价值。方法选择2016年3—6月在同济大学附属第十人民医院因甲状腺结节接受甲状腺手术且经病理检查确诊的甲状腺结节患者180例,对患者进行剪切波弹性成像检查,分别测得结节的杨氏弹性模量及剪切波速度的最大值(E-max)、最大值标准差(E-max-SD)、最大值以正常甲状腺组织为参照的硬度比值(E-max-Ratio),平均值(E-mean)、平均值标准差(E-mean-SD)、平均值以正常甲状腺组织为参照的硬度比值(E-mean-Ratio)。以手术病理检查结果为金标准,绘制以上指标鉴别甲状腺良、恶性结节的受试者工作特征曲线(ROC曲线),分析其对甲状腺良、恶性结节的鉴别诊断价值。结果共选取180例患者的180个结节,其中良性结节69个、恶性结节111个。恶性结节杨氏弹性模量及剪切波速度的E-max、E-max-SD、E-max-Ratio、E-mean、E-mean-SD、E-mean-Ratio均高于良性结节(P0.05)。各指标中,剪切波速度的E-max鉴别甲状腺良、恶性结节的ROC曲线下面积最大[0.793,95%CI(0.727,0.850)],截断值为3.58 m/s,其灵敏度、特异度、阳性预测值、阴性预测值、正确率分别为64.86%、85.51%、87.80%、60.20%、72.78%。结论剪切波弹性成像有助于鉴别良、恶性甲状腺结节,为甲状腺疾病诊断提供了更多的依据。其中,剪切波速度的E-max定量评价的效果更优。
[Abstract]:Objective to investigate the shear wave elastography in diagnosis of thyroid benign and malignant nodules, diagnostic value. Methods from 2016 3 to June in the Tenth People's Hospital Affiliated to Tongji University from thyroid nodules underwent thyroid surgery and 180 patients with thyroid nodules confirmed by pathological examination in the cases of shear wave elastography examination on the patients, the maximum measured Young's elastic nodules modulus and shear wave velocity (E-max), the maximum standard deviation (E-max-SD), the maximum value in normal thyroid tissue as the ratio of hardness reference (E-max-Ratio), average value (E-mean), mean standard deviation (E-mean-SD), the average value of the normal thyroid tissue as the ratio of hardness reference (E-mean-Ratio) on the pathological. Check the operation results as the gold standard, drawing the above indexes in differential diagnosis of thyroid benign and malignant nodules of the receiver operating characteristic curve (ROC curve), analysis of thyroid benign and malignant nodules. The value of differential diagnosis. The results of the 180 nodules in 180 patients were selected, including 69 benign nodules and 111 malignant nodules. The shear modulus and Young's elastic wave velocity of the malignant nodules of E-max, E-max-SD, E-max-Ratio, E-mean, E-mean-SD, E-mean-Ratio were higher than those of benign nodules (P0.05). The indexes in differential diagnosis of thyroid shear E-max wave velocity, maximum [0.793,95%CI area under the ROC curve of malignant nodules (0.727,0.850), the cut-off value of 3.58 m/s, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate were 64.86%, 85.51%, 87.80%, 60.20%, 72.78%. conclusion shear wave elastography is helpful in differentiating benign and malignant. Thyroid nodules, provide more evidence for the diagnosis of thyroid diseases. Among them, E-max quantitative assessment of the shear wave velocity effect better.

【作者单位】：安徽医科大学上海临床学院;同济大学附属第十人民医院超声医学科;同济大学医学院超声医学研究所;
【基金】：国家自然科学基金资助项目(81401417)
【分类号】：R581;R736.1

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