剪切波弹性成像技术定量鉴别诊断甲状腺结节良恶性的初步探讨  

Primary Application of Shear Wave Elastography in Quantitative Differential Diagnosis of Benign and Malignant Thyroid Nodules

作　　者：詹嘉[1] 陈悦[1] 柴启亮[1] 朱隽[1] 陈林[1] 

机构地区：[1]复旦大学附属华东医院超声科,上海市200040

出　　处：《中国超声医学杂志》2012年第3期274-277,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用剪切波弹性成像技术(SWE)定量测定甲状腺结节的弹性模量值(EI),评价该技术对甲状腺结节良恶性鉴别诊断的价值。方法对甲状腺结节患者62例与对照组50例行剪切波弹性成像检查,获得甲状腺结节与正常甲状腺的定量弹性模量值。其中26例单发结节患者行手术,获得病理结果与弹性模量值进行比较。结果病理诊断良性结节21例,恶性5例。恶性结节平均EI为(112.00±32.43)kPa对照良性结节的(39.10±12.82)kPa和正常甲状腺组织的(15.86±4.55)kPa,相互之间差异均有统计学意义(P<0.05)。定量分析甲状腺结节的平均EI值对诊断甲状腺结节良恶性病灶的ROC曲线下面积接近1。以甲状腺结节平均值60 kPa作为诊断界值时,诊断的敏感度、特异度分别为100%,95.2%。结论剪切波弹性成像技术可以定量测定甲状腺结节的EI,为甲状腺结节良恶性鉴别诊断提供依据,有待今后进一步推广和应用。Objective To obtain the quantitative elasticity index（El） of thyroid nodules to assess the value of shear wave elaslrography（SWE） in differential diagnosis of benign and malignant lesion. Methods SWE was per- formed in 62 patients with thyroid nodules and 50 control subjects. 26 patients with single suspicious nodule underwent lhyreoidectomy to get pathologic findings to compare with El. Results 5 noduls（19.2%） were malignant and 21 nod- uls（80.8%） were benign. Mean（±SD） EI was 112.00±32.43 kPa （range,66-145） in malignant nodules vs 39. 104± 12.82 kPa （range,22 60）in benign nodules vs 15.86±4.55 kPa（range,9-25） in control group,respectively（P〈0.05）. The area under tbe ROC curve of mean El was almost 1. For a positive predictive value of at least 80% ,characteristics of tissue elasticity （cutoff, 60 kPa） were： sensitivity 100%, and specificity 95.2%. Conclusions Promising results have been obtained with SWE to improve the differential diagnosis of nodules. Larger prospective studies are needed to confirm these results and to define the respective places of SWE.

关 键 词：剪切波技术 甲状腺结节 弹性模量值 

分 类 号：R445.1[医药卫生—影像医学与核医学]