实时剪切波弹性成像杨氏模量最大值在甲状腺结节良恶性病变风险评估中的价值  

Value of maximum modulus of Young's modulus in evaluating the risk of benign and malignant thyroid nodules in realtime shear wave elastography

作　　者：薛海燕[1] 叶新华[1] 邓红艳[1] 杭菁[1] 许迪[1] 张曾娣 栗翠英[1] 彭晓静[1] 李奥[1] 

机构地区：[1]南京医科大学第一附属医院超声医学科,江苏南京210029 [2]江苏省南京市儿童医院急诊科,江苏南京210029

出　　处：《医学影像学杂志》2017年第11期2069-2072,共4页Journal of Medical Imaging

摘　　要：目的探讨实时剪切波弹性成像(SWE)杨氏模量最大值(Emax)鉴别甲状腺结节病变性质的界值范围及其应用价值。方法常规超声观察252例患者(297个结节)甲状腺结节边界、形态、内部回声、是否合并钙化、纵横比及病灶周边及内部血流情况,同时进行剪切波弹性成像,记录结节Emax值,以手术病理为金标准,采用对数正态分布模型对甲状腺良恶性结节的Emax值进行拟合,获得Emax值鉴别诊断甲状腺结节良恶性的界值范围。结果当Emax<45k Pa,甲状腺良性结节概率>50%;45k Pa≤Emax<70k Pa,甲状腺结节可疑异常病变,良恶性各占50%左右;70k Pa≤Emax<120k Pa,甲状腺恶性结节概率>50%;Emax≥120k Pa,甲状腺恶性结节高度可疑恶性,概率>95%。结论 SWE杨氏模量最大值Emax与甲状腺结节良恶性具有明显的相关性,Emax值对甲状腺结节良恶性风险评估具有一定的临床应用价值。Objective To explore the range of values and application value of the maximum value of Young＇s modulus （Emax） in differentiating benign and malignant thyroid lesions in real-time shear wave elastography （SWE）. Methods Conventional ul- trasound was applied to 297 thyroid nodules （from 252 patients） to observe their two-dimensional ultrasonographic characteristics, such as margins, shape, echoes, presence of calcification, aspect ratio and interior and ambitus blood flow, then SWE was per- formed on these thyroid nodules and the maxim value of Young＇ s modulus （Emax） was recorded. The log normal distribution model was used to fit the Emax of benign and malignant thyroid nodules, according to pathological results to obtain the range of Emax in differentiating benign and malignant thyroid nodules. Results As Emax 〈 45 kPa, the possibility of malignant thyroid nodules is very small, approximately 50% of thyroid nodules are benign; As 45 kPa≤ Emax 〈 70 kPa, thyroid nodules are suspi- cious lesions; when 70 kPa≤Emax 〈 120 kPa, more than 50% of thyroid nodules are suspicious malignant; when Emax≥ 120 kPa, more than 95% of thyroid nodules are highly suspicious malignant. Conclusion The maximum value of Young＇s modulus （Emax） has significant correlation with the pathology of thyroid nodule in real-time shear wave elastography. Emax has high clini- cal value in thyroid nodules benign and malignant risk assessment.

关 键 词：甲状腺结节 风险评估 剪切波弹性成像 杨氏模量最大值 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]