弹性超声与常规超声鉴别甲状腺良恶性肿瘤的比较  

作　　者：施红卫[1] 

机构地区：[1]浙江省丽水市人民医院,323000

出　　处：《浙江临床医学》2018年第8期1447-1449,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探究实时剪切波弹性成像在鉴别甲状腺良、恶性肿瘤方面较常规超声的优势。方法选取2016年9月至2017年9B本院收治的甲状腺结节手术治疗的患者150例，回顾性分析其常规超声、弹性超声检查结果。与术后病理结果进行比较。比较两种超声技术的图像特征及与病理结果的吻合度，以病理结果为标准绘制杨氏模量ROC曲线，分析弹性成像技术鉴别甲状腺良、恶性肿瘤的参考界值。结果病理显示，150个甲状腺结节中良性结节93个（62．0％），恶性结节57个（38．0％），弹性超声鉴别准确度为88.7％，高于二维超声的78．0％，差异有统计学意义（P=0013）；弹性超声良、恶性结节杨氏模量Emax、Emean值的差异有统计学意义（P〈0．05）；杨氏模量Emax、Emean的ROC曲线下面积分别为0．971、0．802，杨氏模量Emax鉴别甲状腺良、恶性结节的最佳诊断界值为90．34kPa，灵敏度90．3％，特异度86．9％杨氏模量Emean鉴别甲状腺良、恶性结节的最佳诊断界值为60．25kPa，灵敏度63．7％，特异度91．7％，二者灵敏度差异有统计学意义（χ2=8．73，P=0．002），特异度差异无统计学意义（P=0．416）。结论弹性超声成像技术可定量测量结节组织硬度，准确性高，在鉴别甲状腺良、恶性肿瘤方面的临床价值高于传统超声，值得临床推广。Objective To investigate the advantages of real time shear wave elastography in differentiating benign and malignant thyroid tumors from conventional ultrasound. Methods From September 2016 to September 2017, 150 cases of thyroid nodules treated in our hospital were retrospectively analyzed. The results of routine ultrasound and elastic plain ultrasonography were compared with the pathological findings during the operation. The image features of two kinds of ukrasound techniques and their coincidence with pathological findings were compared. The young＇s modulus and ROC curve were plotted with pathological results as the standard. The reference values of the differential diagnosis of benign and malignant thyroid tumors were analyzed by elastography. Results The pathological examination showed that 150 thyroid nodules and 93 benign nodules （62%） , 57 malignant nodules （ 38% ） , elastic ultrasonic differential accuracy was 88.7%, 78% higher than that of two-dimensional ultrasound. The difference was statistically significant （P=0.013） ; There were statistically significant differences in elastography in benign and malignant nodules of Young＇s modulus Emax, Emean value （P〈0.05） ; ROC curve area of Young＇s modulus Emax, under Emean were 0.971, 0.802; The best diagnosis of benign and malignant thyroid nodules of the young＇s modulus of Emax differential value is 90.34kPa, and sensitivity is 90.3%, and specificity was 86.9%. The best diagnosis circles of benign and malignant thyroid nodules differential Emean Young＇s modulus value is 60.25kPa, and sensitivity 63.7%, and specificity 91.7%. And two differences was statistically significant （ χ2=8.73, P=0.002 ） . Specificity was not statistically significant （P=0.416） . Conclusion Elastography can be used to measure the rigidity of nodule tissue quantitatively, and the accuracy is high. The clinical value in differentiating benign and malignant thyroid tumors is higher than that of traditional ultrasound, so it is worthy of clinical popu

关 键 词：超声弹性成像 甲状腺结节 常规超声 杨氏模量 

分 类 号：R736.1[医药卫生—肿瘤]