声触诊组织量化成像技术对TI-RADS 4类甲状腺微小结节的诊断价值  

The diagnostic values of virtual touch tissue imaging and quantification for TI-RADS 4 micro-nodules

作　　者：马芬芬[1] 陈烨[1] 娄可新 龚怡 孙景敏 厉志洪 赵华硕 何鹏 MA Fenfen;CHEN Ye;LOU Kexin;GONG Yi;SUN Jingmin;LI Zhihong;ZHAO Huashuo;HE Peng(Department of Medical Ultrasound,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China;Department of Health Statistics,Xuzhou Medical University,Xuzhou,Jiangsu 221004)

机构地区：[1]徐州市中心医院超声医学科,江苏徐州221009 [2]徐州医科大学卫生统计教研室,江苏徐州221004

出　　处：《徐州医科大学学报》2019年第1期49-53,共5页Journal of Xuzhou Medical University

基　　金：江苏高校哲学社会科学研究基金资助项目(2014SJD440)

摘　　要：目的探讨声触诊组织量化成像技术(VTIQ)鉴别TI-RADS 4类甲状腺微小结节良恶性的价值。方法以我院2016年2月至2018年2月经病理证实的甲状腺微小结节患者115例(共129.个结节,最大直径≤1cm)作为研究对象,其中良性结节76枚,恶性结节53枚,采用VTIQ技术测量结节剪切波速度(SWV)。以病理诊断为金标准,绘制ROC曲线评价VTIQ技术的诊断效能。结果VTIQ的参数剪切波速度均值(SWVmean)、剪切波速度标准差(SWVstd)、剪切波速度最大值(SWVmax)、剪切波速度最小值(SWVmin)和剪切波速度比值(SWVratio)在甲状腺恶性结节的取值均高于良性结节(P均<0.05)。上述SWV参数在鉴别诊断甲状腺微小结节的良恶性时具有一定的价值(P均<0.05)。当SWVmean的截断值=2.742 m/s时,灵敏度为75.5%,特异度为92.1%,阳性预测值为87.0%,阴性预测值为84.3%。结论SWV的恶性结节取值要高于良性结节,VTIQ能很好地反映良恶性结节在生物学上的异质性,对甲状腺微小结节的鉴别诊断有较大的应用价值。当SWVmean大于2.742 m/s时应提高警惕,提示可能为恶性结节。Objective To evaluate the values of virtual touch tissue quantification (VTFQ)for differentiate diagno- sis of benign and malignant micro-nodules of TI-RADS 4.Methods A total of 115 patients who were pathologically diagnosed (129 micro-nodules with a diameter≤10 mm,including 76 benign nodules and 53 malignant nodules)in our hospital from February 2016 to February 2018 were selected.They underwent VTIQ examinations where the shear wave velocities (SWVs)of the nodules were measured.Using surgical pathological results as the gold standard,and the receiver operating characteristic curve (ROC)was used to assess the value of VTIQ in differentiate diagnosis of benign and malignant micro -nodules.Results Compared with benign nodules,malignant ones demonstrated remarkably higher values of SWV SWVstd,SWVmx=,SWVmin and SWVratio(all P <0.05).This finding indicated the value of the five SWV indices for differentiate diagnosis of benign and malignant micro -nodules.When the optimal cutoff value of SWVmean was set as 2.742 m/s,the diagnostic sensitivity was 75.5%,the specificity was 92.1%,the positive predictive value was 87.0% and the negative predictive value was 84.3%.Conclusions VTIQ is valuable in differentiate diagnosis of benign and malignant micro -nodules.

关 键 词：声触诊组织量化成像技术 甲状腺微小结节 鉴别诊断 TI-RADS分级 

分 类 号：R730.41[医药卫生—肿瘤]