声触诊组织量化技术对甲状腺实性小结节良恶性的鉴别诊断价值  

Value of virtual touch tissue quantification technique in the diagnosis of small solid thyroid nodules

作　　者：肖莉莉[1] 赵雅萍[1] 高凌云[1] 张海燕[2] 叶兵[3] 吕夕明[1] 许崇永[4] 

机构地区：[1]温州医学院附属第二医院超声科,325027 [2]温州医学院附属第二医院病理科,325027 [3]温州医学院附属第二医院肿瘤外科,325027 [4]温州医学院附属第二医院放射科,325027

出　　处：《中华超声影像学杂志》2012年第9期771-774,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨声触诊组织量化（VTQ）技术在甲状腺实性小结节良恶性鉴别诊断中的应用价值。方法选择常规超声难以鉴别良恶性的甲状腺实性单发结节，结节最大径范围5～15mm，甲状腺实质回声均匀，血供正常的病例，应用VTQ技术测量甲状腺结节及非结节部位各5次，根据剪切波速度（Vs）绘制ROC曲线。结果共62例患者67个病灶入选，其中恶性39个，良性28个。恶性组结节、恶性组非结节部、良性组结节、良性组非结节部Vs分别为（3．91±1．85）m／s、（2．03±0．42）m／s、（2．29±0．56）m／s、（1．84±0．45）m／s。良、恶性结节Vs差异有统计学意义（P=0．000），良、恶性结节的非结节部Vs差异无统计学意义（P=0．07）。以2．78m／s为截断值诊断甲状腺恶性病变的灵敏度、特异度及准确度分别为76．9％、78．6％、80．6％，ROC曲线下面积为0．84。结论VTQ技术可用于评价甲状腺结节硬度，为判断其良恶性提供一定的诊断依据。Objective To explore the application value of virtual touch tissue quantification（VTQ） technique in differentiating small solid thyroid nodules. Methods The patients with suspiciously malignant thyroid nodules（solitary, size range 5 - 15 mm）, homogeneous and normal color Doppler flow imaging in the rest of thyroid parenchyma,were enrolled in this study. Five repeated measurements were performed on both nodules and extra-nodular tissues using VTQ. A receiver-operating characteristic （ROC） curve was drew according to shear wave velocity（Vs）. Results 62 patients with a total of 67 lesions were included in this study,turned out to be 39 malignant and 28 benign. The Vs of malignant group nodules, malignant group extra-nodular tissues, benign group nodules and benign group extra-nodular tissues were （3.91± 1.85） m/s, （2.03 ± 0.42） m/s, （2.29 ± 0.56） m/s, （ 1.84 ± 0.45） m/s, respectively. The Vs difference between malignant and benign nodules was statistically significant （ P = 0. 000）, while the Vs difference between malignant and benign extra-nodular tissues had no statistical significance （ P = 0.07）. The best cut- off Vs value for distinguishing malignant from benign nodules was 2.78 m/s, with the sensitivity, specificity and accuracy of 76.9% ,78.6% and 80.6% respectively. The area under ROC curve was 0.84. Conclusions VTQ could evaluate the elasticity of thyroid nodules ,and was helpful in the diagnostic work-up of thyroid nodules.

关 键 词：超声检查 甲状腺肿瘤 声触诊组织量化技术 

分 类 号：R445.1[医药卫生—影像医学与核医学]