高b值扩散加权成像与超声弹性成像在甲状腺微小乳头状癌诊断中的对比研究  

Comparison of high b-value DWI and ultrasound elastography in the diagnosis of papillary thyroid microcarcinoma

作　　者：张君[1] 付万袭 逯巧慧 陆伟 胡莹莹 王庆军[1] ZHANG Jun;FU Wanxi;LU Qiaohui;LU Wei;HU Yingying;WANG Qingjun(Department of Medical Imaging,the Sixth Medical Center of Chinese PLA General Hos pital,Beijing 100048,China;Department of Ultrasound,the Sixth Medical Center of Chinese PLA General Hos pital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心医学影像科,北京100048 [2]解放军总医院第六医学中心超声科,北京100048

出　　处：《实用放射学杂志》2020年第1期25-29,共5页Journal of Practical Radiology

摘　　要：目的探讨高b值DWI检查与超声弹性成像对甲状腺微小乳头状癌(PTMC)的诊断价值,并做对比分析.方法选取拟行手术的甲状腺微小结节患者78例,术前均常规进行甲状腺DWI检查及超声弹性成像检查并与手术结果做对比,计算2组诊断甲状腺微小结节良恶性的灵敏度、特异度、阳性预测值、阴性预测值,Youden指数,并比较2种诊断方法的准确性.结果经手术病理证实的36例PTMC及42例良性微结节进行了高b值DWI诊断及超声弹性成像.高b值DWI诊断PTMC的灵敏度91.7%,特异度83.3%,阳性预测值82.5%,阴性预测值92.1%,Youden指数0.75;超声弹性成像诊断PTMC的灵敏度88.9%,特异度78.5%,阳性预测值78.0%,阴性预测值89.1%,Youden指数0.674;高b值DWI及超声弹性成像2组灵敏度及特异度的差别无统计学意义(灵敏度:χ^2=1.636,P=0.305>0.05;特异度:χ^2=2.291,P=0.155>0.05).2种诊断方法具有较高一致性(Kappa=0.974,P<0.001).结论高b值DWI检查、超声弹性成像作为新的诊断技术,对于PTMC的诊断均具有较高的诊断价值.Objective To investigate and compare the diagnostic value of high b-value DWI and ultrasound elastography in the diagnosis of papillary thyroid microcarcinoma(PTMC).Methods A total of 78 patients with thyroid micro nodules planned for thyroid operation underwent routine DWI and ultrasound elastography of thyroid.With pathologic results as the reference standard,the sensitivity,specificity,positive predictive value,negative predictive value and Youden's index were analyzed.The accuracy of the two diagnostic methods were compared.Results 36 cases of PTMC and 42 cases of benign thyroid nodules confirmed by pathology underwent high b-value DWI and ultrasound elastography.The sensitivity,specificity,positive predictive value,negative predicive value and Youden's index of high b-value DWI were 91.7%,83.3%,82.5%,92.I%,0.75,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and Youden's index of ultrasound elastography were 88.9%,78.5%,78.0%,89.1%,0.674,respectively.However,the difference between the two did not show statistical significance(sensitivity:x^2=1.636,P=0.305>0.05;specifieity:x^2=2.291,P=0.155>0.05).The Kappa statistic by two diagnostic methods was excellent(Kappa=0.974,P<0.001).Conclusion As a novel diagnostic technology,high b-value DWI and ultrasound elastography have high diagnostic value for PTMC.

关 键 词：甲状腺微小乳头状癌 扩散加权成像 超声弹性成像 

分 类 号：R736.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]