声触诊组织定量成像技术诊断甲状腺乳头状癌硬度影响因素分析  

Analysis of influencing factors on the hardness of papillary thyroid carcinoma diagnosed by virtual touch tissue quantification technology

作　　者：丁赫 徐辉雄[1] 徐军妹[1] 李小龙[1] 伯小皖 刘博姬 贺亚萍[1] 房林[1] 曲伸[1] 

机构地区：[1]上海市第十人民医院同济大学附属第十人民医院超声医学科同济大学医学院超声医学研究所,200072 [2]上海普陀区人民医院超声科

出　　处：《中华医学超声杂志（电子版）》2017年第2期134-140,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金(81501475);上海市科委生物医药领域科技支撑项目(14441900900);上海市科委引导项目(15411969000)

摘　　要：目的分析影响声触诊组织定量成像(VTQ)技术诊断甲状腺乳头状癌(PTC)硬度的因素。方法选取2011年5月至2014年3月同济大学附属第十人民医院经手术病理证实的PTC患者266例共266个结节。采用VTQ技术检测PTC剪切波速度(SWV)值。将PTC分为SWV值≥2.87 m/s与SWV值<2.87 m/s 2组。采用χ2检验比较2组PTC患者超声声像图特征。采用Logistic回归分析分析PTC SWV值的影响因素。结果 266个PTC中,183个SWV值≥2.87 m/s,83个SWV值<2.87 m/s。2组PTC结节单多发、中央区淋巴结有无转移、位置、大小、形态、后方回声有无衰减、有无钙化、有无包膜浸润、是否贴近气管等差异均有统计学意义(χ2=4.233、4.740、9.910、4.988、4.907、4.416、4.737、7.154、8.559,P均<0.05或0.01);Logistic回归分析结果显示,结节单多发、位置、后方回声有无衰减、有无钙化、是否贴近气管是PTC SWV值的影响因素。回归方程为:Y=-2.507+0.670X1(结节单多发)+0.800 X3(位置)+0.851 X6(后方回声有无衰减)+0.628 X7(有无钙化)+1.106 X9(是否贴近气管)。结论结节多发、有中央区淋巴结转移、位于峡部、结节大小>10 mm、形态不规则、后方回声有衰减、有钙化、有包膜浸润、贴近气管与VTQ技术诊断PTC具有相关性,其中结节多发、位于峡部、后方回声有衰减、有钙化、贴近气管这些特征越多,PTC越硬。Objective To analyse the influencing factors diagnosed by the virtual touch tissue quantification （VTQ） technology on the hardness of papillary thyroid carcinoma （PTC）. Methods From May 2011 to March 2014, a total of 266 PTCs in 266 patients confirmed by pathology were enrolled in Shanghai Tenth People＇s Hospital. The shear wave velocity （SWV） values of PTCs were measured by VTQ. PTCs were divided into 2 groups including SWV ≥ 2.87 m/s and SWV 〈 2.87 m/s. The χ2 test was used to compare the basic clinical data, ultrasound features and immunohistochemical results between 2 groups. The influencing factors of SWV values of PTCs were analyzed by forward stepwise Logistic regression analysis. Results Of the 266 PTCs, 183 were SWV ≥ 2.87 m/s and 83 were SWV 〈 2.87 m/s. The χ2 test showed that the ultrasound features of PTCs such as single or multiple, with or without central lymph node metastasis, location, size, shape, with or without posterior acoustic attenuation, with or without calcification, with or without capsule invasion, whether close to the trachea between the 2 groups were significant different （χ2=4.233, 4.740, 9.910, 4.988, 4.416, 4.737, 7.154, 8.559, all P 〈 0.05 or 0.01）. Logistic regression analysis demonstrated that nodules were single or multiple, location, with or without posterior acoustic attenuation, with or without calcification, whether close to the trachea were influencing factors of SWV value of PTCs. The regression equation was defined as Y=-2.507 W 0.670X~ （nodules were single or multiple） ＋ 0.800X3 （location of nodules） ＋ 0.851X6 （with or without posterior acoustic attenuation） ＋ 0.628X7 （with or without calcification） ＋ 1.106X9 （whether close to the trachea）. Conclusions Multiple nodules, central lymph node metastasis, located isthmus, nodules size 〉 10 mm, irregular shape, posterior acoustic attenuation, calcification, capsule invasion, close to the trachea were correlated with the diagnosis of PTC by VTQ technology. The more c

关 键 词：弹性成像技术 甲状腺肿瘤 硬度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]