组织弥散定量技术在甲状腺结节鉴别诊断中的价值探讨  

The application value of the tissue dispersion quantitative analysis technique in differentiating thyroid nodules

作　　者：张传菊[1] 赵博文[1] 吕江红[1] 徐海珊[1] 寿金朵[1] 许立龙[1] 杨黎明[1] 朱江[1] Zhang Chuanju;Zhao Bowen;Lyu Jianghong;Xu Haishan;Shou Jinduo;Xu Lilong;Yang Liming;Zhu Jiang(Department of Diagnostic Ultrasound,Sir Run Run Shaw Hospital of Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院超声科,杭州310016

出　　处：《中华超声影像学杂志》2020年第10期870-874,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81974470,81471664);浙江省自然科学基金(LY18H180001)。

摘　　要：目的探讨弹性成像组织弥散定量技术评价甲状腺良恶性结节的应用价值。方法对2014年1-11月浙江大学医学院附属邵逸夫医院143例甲状腺结节患者共164枚结节进行弹性超声检查,应用组织弥散定量分析软件对所有病灶进行分析,获得11个参数,并对11个参数进行良恶性组间比较分析,采用Spearman等级相关分析各参数与病理良恶性间的相关性,选择相关系数最高的参数构建ROC曲线,计算出诊断界点。结果11个参数中,除了相关性(CORR)良恶性组间比较差异无统计学意义,其余参数组间比较差异有统计学意义(均P<0.01)。除CORR外,余参数与病理良恶性诊断有相关性(均P<0.05),其中以蓝色面积比例(%AREA)相关系数最高(rs=0.818)。以%AREA诊断甲状腺癌绘制ROC曲线,曲线下面积为0.991,以74.83%为诊断界点,诊断甲状腺癌的敏感性为98.1%、特异性为89.8%。结论弹性成像组织弥散定量技术在甲状腺结节的良恶性鉴别诊断中具有重要意义。Objective To investigate the application value of the ultrasonic elastic tissue dispersion quantitative analysis technique in differentiating thyroid nodules.Methods A total of 164 nodules in 143 patients with thyroid nodules were examined by elastography ultrasound at Sir Run Run Shaw Hospital of Zhejiang University School of Medicine from January to November 2014.Eleven parameters were obtained by the tissue dispersion quantitative analysis software.These parameters were compared between benign and malignant groups by Mann-Whitney U test.The correlations between all the parameters and the pathologic results of thyroid nodules were analyzed by Spearman analysis.The receiver operating characteristic(ROC)curve of the parameter with the highest correlation coefficient was constructed.The cut-off value was calculated.Results All parameters except correlation(CORR)had statistically significant differences between the groups of benign and malignant thyroid nodules(all P<0.01).Moreover,except CORR,the other parameters were correlated with the pathologic results of thyroid nodules(all P<0.05),with the highest coefficient in area ration of low-strain region(%AREA)(rs=0.818).ROC curves were constructed to estimate the clinic values of%AREA in diagnosis of thyroid cancer,the area under ROC curve was 0.991 for%AREA,the cut-off point was 74.83%,the sensitivity and specifity was 98.1%and 89.8%,respectively.Conclusions The tissue dispersion quantitative analysis technique has high value in the differential diagnosis of benign and malignant thyroid nodules.

关 键 词：超声检查 甲状腺结节 组织弥散定量技术 

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]