剪切波联合“萤火虫”成像技术对TI-RADS 4级甲状腺结节的诊断价值  

The Diagnostic Value of Shear Wave Elastography Combined with Micropure Imaging in the Differentiation of the Thyroid Nodules of TI-RADS 4

作　　者：许聪颖[1] 崔可飞[1] 马笑[1] 黄媛婧[1] 郭艳飞[1] 

机构地区：[1]郑州大学第一附属医院超声诊断中心,郑州市450002

出　　处：《中国超声医学杂志》2016年第6期484-487,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时剪切波弹性成像技术(SWE)联合"萤火虫"成像技术对TI-RADS 4级甲状腺结节良恶性评估的应用价值。方法对93例TI-RADS 4级甲状腺结节患者行常规超声、"萤火虫"成像及SWE检查,并获取杨氏模量平均值(Emean),以术后病理结果为金标准绘制ROC曲线,得出最佳界值点。将Emean低于最佳界值+"萤火虫"微钙化阴性的4级结节下调至TI-RADS 3级,将Emean高于最佳界值+"萤火虫"微钙化阳性的4级结节上调至5级,其他情况维持不变,分析调整前后对TI-RADS 4级结节的诊断效能。结果常规超声检查判为4级结节93例,调整后39例降为3级,其中恶性2例,良性37例;调整后27例升至5级,其中恶性24例,良性3例。结论对于常规超声判为4级的甲状腺结节,剪切波弹性技术联合"萤火虫"可进一步提高诊断的准确度,有效降低4级结节的穿刺率。Objective To evaluate the diagnostic value of Shear Wave Elastography（SWE）and Micropure Imaging in the differentiation of the thyroid nodules of TI-RADS 4.Methods 93 nodules of TI-RADS 4 were performed of conventional US,SWE and Micropure examination,and the mean Young modulus（Emean）was obtained.With the pathological results as gold standard,ROC curve was drawn to get the threshold value.By comparing Emean with the threshold value and the result of Micropure imaging,category 4a nodules with lower Emean,which was companied without microcalcification,were defined as grade 3,while 4a ones with higher Emean companied with microcalcification,they were defined as grade 5 the and others remained unchanged.Then its diagnostic value was determined.Results The 93 nodules were picked up to grade 4 by routine ultrasound.After the adjustment,39 cases were dignosed as grade 3,which were composed of 2 malignant ones and 37 benign ones;27 cases were diagnosed as grade 5,which were composed of 24 malignant nodules and 3 benign nodules.Conclusions SWE combining with micropure imaging can improve the accuracy in diagnosing the nodules of TI-RADS grade 4 at conventional us,and reduce rate of the puncture.

关 键 词：超声 剪切波弹性成像 “萤火虫”成像 甲状腺影像报告与数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]