灰阶超声和ARFI-VTQ对最大径小于1cm甲状腺微小乳头状癌的诊断价值  

Grey-scale sonography and ARFI-VTQ in diagnosis of papillary thyroid microcarcinoma smaller than 1 cm

作　　者：姜露莹[1] 蔡应娱[1] 何颖倩[1] 顾继英[1] 杜联芳[1] 杨亚汝[1] 

机构地区：[1]上海交通大学附属第一人民医院超声医学科,上海200080

出　　处：《肿瘤》2016年第2期202-207,共6页Tumor

摘　　要：目的 :评价灰阶超声和声脉冲辐射力成像-声触诊组织定量(acoustic radiation force impulse-virtual touch quantification,ARFI-VTQ)技术对最大径小于1 cm的甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的诊断价值。方法 :收集195例病理诊断明确的最大径小于1 cm的甲状腺结节的灰阶超声和ARFI-VTQ弹性超声声像资料,回顾性分析2种超声检查方法的诊断价值。结果 :195个甲状腺小结节中,甲状腺乳头状癌92个,良性结节103个。灰阶超声的纵横比、边界、声晕及侧方声影对PTMC有重要的诊断价值,灰阶超声诊断的敏感度为77.2%,特异度为80.6%,准确度为79.0%,阳性预测值为78.0%,阴性预测值为79.8%。采用ARFI判定结节的性质,当VTQ的剪切波速度(shear wave velocity,SWV)临界值为2.98 m/s时,敏感度为72.8%,特异度为77.7%,准确度为75.2%,阳性预测值为76.5%,阴性预测值为74.1%。2种超声检查方法的总体诊断价值无明显差异。结论:对最大径小于1 cm的PTMC应以灰阶超声检查为基础,联合ARFI-VTQ能够增强诊断的信心。Objective： To evaluate the value of grey-scale sonography and acoustic radiation force impulse-virtual touch quantification（ARFI-VTQ） elastography in diagnosis of papillary thyroid microcarcinoma smaller than 1 cm.Methods： Grey-scale sonography and ARFI-VTQ elastography were performed on 195 thyroid nodules smaller than 1 cm which were verified by pathologic results. The sonographic features and quantitative elasticity features（VTQ） were observed and analyzed.Results： Of 195 thyroid nodules, 92 were papillary carcinoma, 103 were benign nodules. The features of grey-scale sonography including shape, boundary, halo and lateral shadow were important to diagnose papillary microcarcinoma. The diagnostic sensitivity, specificity, accuracy, and positive and negative predictive values of grey-scale sonography were 77.2%, 80.6%, 79.0%, 78.0% and 79.8%, respectively; while those of ARFI-VTQ were 72.8%, 77.7%, 75.2%, 76.5% and 74.1%, respectively, with the cut-off value of shear wave velocity（SWV） for differential diagnosis set at 2.98 m/s. There was no significant difference between the two methods.Conclusion： Grey-scale sonography should be used to diagnose thyroid nodules smaller than 1 cm as first choice, combined with ARFI-VTQ can increase diagnostic confidence.

关 键 词：甲状腺肿瘤 微小乳头状癌 灰阶超声 弹性成像 定量 

分 类 号：R736.1[医药卫生—肿瘤]