剪切波弹性成像诊断^(18)F-FDG PET/CT显像甲状腺局灶性高代谢偶发瘤  

Shear wave elastography in diagnosis of ^(18)F-FDG PET/CT hypermetabolic incidental thyroid focal nodules

作　　者：欧阳向柳 郑立春[2] 王艳滨 张文军[2] 张晓明[2] 胡月明[3] OUYANG Xiangliu;ZHENG Lichun;WANG Yanbin;ZHANG Wenjun;ZHANG Xiaoming;HU Yueming(Department of Ultrasound,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Nuclear Medicine,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Pathology,Tangshan Gongren Hospital,Tangshan 063000,China)

机构地区：[1]唐山市工人医院超声诊断科,河北唐山063000 [2]唐山市工人医院核医学科,河北唐山063000 [3]唐山市工人医院病理科,河北唐山063000

出　　处：《中国医学影像技术》2018年第10期1479-1483,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超声剪切波弹性成像对^(18)F-FDG PET/CT显像高代谢的甲状腺局灶性良恶性偶发瘤的诊断价值。方法对因非甲状腺疾病接受^(18)F-FDG PET/CT显像、并存在甲状腺局灶性高代谢偶发瘤的61例患者(67个病灶)行超声剪切波弹性成像,测量偶发瘤的剪切波速度(SWV),联合常规二维超声判断甲状腺偶发瘤的良恶性,并与病理结果对照,比较良恶性偶发瘤间SWV值的差异,以ROC曲线评价SWV值的诊断效能。结果 67个高代谢偶发瘤中,恶性38个,良性29个。常规二维超声联合剪切波弹性成像诊断恶性偶发瘤的敏感度为89.47%(34/38),特异度为86.21%(25/29),准确率为88.06%(59/67)。良性和恶性偶发瘤的SWV分别为(2.06±0.75)m/s和(4.64±1.75)m/s,差异有统计学意义(t=8.133,P<0.001)。ROC曲线分析结果显示,SWV值诊断恶性偶发瘤的AUC为0.946(P<0.001),临界值为2.28m/s时,敏感度为97.4%,特异度为82.8%,约登指数最大,为0.802。结论超声剪切波弹性成像对^(18)F-FDG PET/CT显像高代谢甲状腺局灶性偶发瘤具有较高诊断价值,以SWV=2.28m/s为临界值时诊断效能最大。Objective To investigate the diagnostic value of shear wave elastography in diagnosis of benign and malignant 18 F-FDG PET/CT hypermetabolic incidental thyroid focal nodules.Methods Totally 61 patients with 67 incidental thyroid focal nodules hypermetabolic in 18 F-FDG PET/CT were collected.Shear wave velocity(SWV)of these thyroid focal nodules were measured.The qualitative diagnosis of benign or malignant was made with shear wave elastography combining with conventional ultrasound and pathological results.SWV of benign and malignant incidental thyroid nodules were compared,and ROC curve of SWV in the diagnosis of malignant incidental thyroid nodules was analyzed.Results In all of the 67 incidental thyroid focal hypermetabolic nodules,38 were malignant and 29 were benign.The sensitivity,specificity,accuracy of shear wave elastography combining with conventional ultrasound in the diagnosis of malignant incidental nodules were 89.47%(34/38),86.21%(25/29)and 88.06%(59/67),respectively.SWV of malignant and benign incidental nodules was(4.64±1.75)m/s and(2.06±0.75)m/s,respectively(t=8.133,P<0.001).AUC of ROC curve for SWV in diagnosis of malignant incidental nodules was 0.946(P<0.001).Taking SWV=2.28 m/s as the threshold,the sensitivity was 97.4%,and the specificity was 82.8%with the highest Youden index as 0.802.Conclusion Shear wave elastography has high diagnostic value of incidental thyroid focal nodules hypermetabolic in 18 F-FDG PET/CT,and taking SWV=2.28 m/s as the threshold is the best.

关 键 词：超声检查 剪切波弹性成像 甲状腺结节 偶发瘤 体层摄影术 发射型计算机 

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