声触诊组织弹性成像鉴别诊断甲状腺结节良恶性的价值  

Value of virtual touch tissue imaging in the differential diagnosis of benign and malignant thyroid nodules

作　　者：何勇[1] 徐辉雄[1] 张一峰[1] 刘媛媛[1] 刘畅[1] 郭乐杭[1] 吴蓉[1] 刘琳娜[1] 

机构地区：[1]同济大学影像临床医学中心同济大学附属第十人民医院超声医学科,上海200072

出　　处：《中华超声影像学杂志》2012年第4期320-323,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：教育部新世纪优秀人才支持计划项目（NCET-06-0723）

摘　　要：目的探讨声脉冲辐射力声触诊组织弹性成像（virtual touch tissue imaging，VTI）定性诊断甲状腺结节良恶性的价值。方法观察经病理证实的74例患者共77个甲状腺结节的VTI图像特征，并将图像分为6级，级数越高代表组织硬度越大。应用ROC曲线分析VTI分级诊断甲状腺结节良恶性的最佳诊断点，并计算其敏感度、特异性及准确率。结果77个甲状腺结节病理证实良性病变61个，恶性病变16个。恶性病变中VTI图像分别为I级0个，Ⅱ级1个，Ⅲ级1个，Ⅳ级9个，V级3个及Ⅵ级2个；良性病变中VTI图像分别为I级18个，Ⅱ级28个，Ⅲ级10个，Ⅳ级1个，V级2个及Ⅵ级2个。VTI弹性分级最佳诊断点为Ⅳ级，Ⅳ级及Ⅳ级以上诊断恶性甲状腺结节的敏感度、特异性及准确率分别为87．5％、91．8％、90．90A。结论VTI可帮助判断甲状腺结节的良恶性。Objective To explore the value of virtual touch tissue imaging （VTI） of acoustic radiation force impulse （ARFI） elastography in the differential diagnosis of benign and malignant thyroid nodules. Methods VTI features of 77 histologically proven thyroid nodules in 74 patients were analyzed and the VTI features were divided into 6 grades. The higher grade represented higher tissue stiffness. Differences in VTI grade between benign and malignant lesions were analyzed by receiver operator characteristic （ROC） curve, and the sensitivity, specificity and accuracy were calculated. Results 77 pathologically proven thyroid nodules included 61 benign and 16 malignant lesions. VTI images classification included 0 in grade I , 1 in grade II ,1 in grade III ,9 in grade IV ,3 in grade V and 2 in grade VI for malignant diseases;and included 18 in grade I ,28 in grade II ,10 in grade III ,1 in grade IV ,2 in grade V and 2 in grade VI for benign diseases. The best diagnostic point of VTI-grade was grade IV. When VTI-grade IV or greater was used as the diagnostic criterium for malignancy, the sensitivity, specificity and accuracy rate in differentiation between benign and malignant thyroid nodules were 87.50 % ,91.80 % and 90.90 % respectively. Conclusions VTI is useful in the differential diagnosis between benign and malignant thyroid nodules.

关 键 词：超声检查 甲状腺肿瘤 声触诊组织成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]