声脉冲辐射力成像在甲状腺良恶性结节鉴别诊断中的应用  

Usefulness of Acoustic Radiation Force Impulse Imaging in the Differential Diagnosis of Benign and Malignant Thyroid Nodules

作　　者：邓金[1] 周平[1] 张露[1] 田双明[1] 马树花[1] 伍小敏[1] 

机构地区：[1]中南大学湘雅三医院,湖南长沙410013

出　　处：《中国医学创新》2013年第6期97-99,共3页Medical Innovation of China

摘　　要：目的：应用ARFI对甲状腺结节的硬度进行评估,探讨ARFI在鉴别诊断甲状腺良恶性结节中的应用价值.方法：采用ARFI对90例患者102个甲状腺结节（75个良性,27个恶性）进行检查,获取并分析甲状腺良恶性结节的声触诊组织定量（virtual touch tissue quantication,VTQ）值.通过绘制ROC曲线获得VTQ值的曲线下面积以及最佳截断点,评价其诊断效能.所有病例均经病理证实.结果：恶性结节VTQ值中位数为3.04 m/s,平均（3.43±1.13）m/s,范围2.25~6.90 m/s;良性结节中位数为2.10 m/s,平均（2.08±0.62）m/s,范围0.72~4.24 m/s;甲状腺结节周边组织的中位数为1.91 m/s,平均（1.95±0.377）m/s,范围1.23~2.38 m/s.甲状腺恶性结节VTQ值要明显高于甲状腺良性结节,比较差异具有统计学意义（P0.05）.当VTQ截断点为2.60 m/s时,其预测甲状腺恶性结节的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为87.0%、88.7%、87.3%、70.6%、95.6%.结论：ARFI可显著提高甲状腺良恶性结节的鉴别诊断能力,是一项很有发展前景的诊断技术.Objective：To evaluate the tissue stiffness of thyroid nodules by ARFI to differentiate benign from malignant thyroid lesions. Method：The ARFI technique was performed in 90 patients with 102 thyroid nodules（75 benign,27 malignant）. The values of virtual touch tissue quantication （VTQ）were obtained and analyzed. The area under the curve and cut-off point,both of which were obtained by using a receiver operating characteristic curve analysis,were used to assess diagnostic performance. Final diagnosis was established by histopathology. Result：The VTQ median value of malignant nodules,a benign nodules,and the surrounding thyroid parenchyma was 3.04 m/s,mean（3.43±1.13）m/s,range 2.25-6.90 m/s,2.10 m/s,mean （2.08±0.62）m/s,range 0.72-4.24 m/s,1.91 m/s,mean（1.95±0.377）m/s,range 1.23-2.38 m/s,respectively. The VTQ of thyroid malignant nodules was significant higher than that of the benign thyroid nodules. There were statistical differences between malignant and benign nodules（P〈0.001）. With a cut-off value of 2.60 m/s for VTQ value,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value for malignancy was 87.0%,88.7%,87.3%,70.6%,and 95.6%,respectively. Conclusion：ARFI can significantly improve diagnosis ability in the differentiation between benign and malignant thyroid nodules,which became a very promising diagnostic technique.

关 键 词：声脉冲辐射力成像 甲状腺结节 

分 类 号：R581[医药卫生—内分泌] R736.1[医药卫生—内科学]