SWE成像技术联合血流灌注参数Peak、Tp、MTT对甲状腺良恶性结节的诊断价值  

The diagnostic value of SWE imaging technology combined with blood perfusion parameters Peak,Tp and MTT for benign and malignant thyroid nodules

作　　者：阿吉古丽·玉山 张利[1] 布阿依夏木·艾比 AJIGULI·Yu-shan;ZHANG Li;BUAYIXIAMU·Ai-bi(Department of Ultrasound,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Ultrasound,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院超声科,新疆乌鲁木齐830001 [2]新疆医科大学第六附属医院超声二科,新疆乌鲁木齐830000

出　　处：《中国临床医学影像杂志》2021年第10期708-713,共6页Journal of China Clinic Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金:2017D01C120。

摘　　要：目的:探究实时剪切波弹性成像(SWE)技术联合超声造影(CEUS)对甲状腺良恶性结节的诊断价值。方法:选取我院2017年1月—2019年1月甲状腺恶性结节患者72例(101个结节)作为恶性组,甲状腺良性结节患者72例(98个结节)作为良性组,均行SWE、CEUS检查,以手术病理诊断结果作为“金标准”,比较两组SWE成像参数(弹性模量最大值(E_(max))、弹性模量最小值(E_(min))、弹性模量平均值(E_(mean)))、CEUS血流灌注参数(峰值强度(Peak)、达峰时间(Tp)、平均通过时间(MTT)),评价SWE成像参数与Peak、Tp、MTT相关性,并评价各参数对甲状腺良恶性结节诊断的价值,对比恶性组与良性组不同大小结节患者SWE成像参数、CEUS血流灌注参数,探究各参数对不同大小甲状腺良恶性结节的诊断价值。结果:恶性组E_(max)、E_(min)、E_(mean)、Tp、MTT高于良性组,Peak低于良性组(P<0.05);E_(max)、E_(min)、E_(mean)与Tp、MTT呈正相关,与Peak呈负相关(P<0.05);SWE成像参数、CEUS血流灌注参数联合鉴别诊断甲状腺良恶性结节的AUC大于各指标单一鉴别诊断,为0.884,最佳诊断敏感度、特异度分别为86.27%、81.63%;恶性组结节>10 mm患者E_(max)、E_(min)、E_(mean)、Tp、MTT高于结节≤10 mm患者,Peak低于结节≤10 mm患者(P<0.05);SWE成像参数、CEUS血流灌注参数联合诊断>10 mm甲状腺结节良恶性的AUC大于单一诊断,为0.880,最佳诊断敏感度、特异度分别为85.19%、76.74%;SWE成像参数、CEUS血流灌注参数联合诊断≤10 mm甲状腺结节良恶性的AUC大于单一诊断,为0.873,最佳诊断敏感度、特异度分别为78.72%、85.45%。结论:SWE成像参数,CEUS血流灌注参数Peak、Tp、MTT联合在甲状腺结节良恶性鉴别诊断方面具有较高应用价值,但其鉴别诊断≤10 mm和>10 mm甲状腺结节良恶性的截断值不同,临床应用中应加以区分。Objective:To explore the diagnostic value of real-time shear wave elastography(SWE)combined with contrastenhanced ultrasound(CEUS)for benign and malignant thyroid nodules.Methods:From January 2017 to January 2019,72 patients with malignant thyroid nodules(101 nodules)were selected as the malignant group,and 72 patients(98 nodules)with benign thyroid nodules were selected as the benign group.SWE and CEUS examinations were performed,with surgical pathological diagnosis results as the“gold standard”.The SWE imaging parameters(maximum elastic modulus(E_(max)),minimum elastic modulus(E_(min)),mean elastic modulus(E_(mean)))and CEUS blood perfusion parameters(peak intensity(Peak),time to peak(Tp),mean transit time(MTT))of the two groups were compared.The correlation between SWE imaging parameters and Peak,Tp,MTT was evaluated,and the value of each parameter in the diagnosis of thyroid benign and malignant nodules was evaluated.The SWE imaging parameters and CEUS blood perfusion parameters of nodules with different sizes in the malignant group and the benign group were compared,and the diagnostic value of each parameter for benign and malignant thyroid nodules of different sizes was explored.Results:E_(max),E_(min),E_(mean),Tp,and MTT of the malignant group were higher than those of the benign group,and Peak was lower than the benign group(P<0.05).E_(max),E_(min),E_(mean) were positively correlated with Tp and MTT,and negatively correlated with Peak(P<0.05).The AUC of the combined differential diagnosis of SWE imaging parameters and CEUS blood perfusion parameters for benign and malignant thyroid nodules was greater than the single differential diagnosis of each index,which was 0.884.The best diagnostic sensitivity and specificity were 86.27%and 81.63%respectively.The E_(max),E_(min),E_(mean),Tp,MTT of patients with nodules>10 mm in the malignant group were higher than those with nodules≤10 mm,and Peak was lower in patients with nodules≤10 mm(P<0.05).The combined diagnosis value of SWE imaging parameters and CEU

关 键 词：甲状腺肿瘤 弹性成像技术 超声检查 多普勒 彩色 

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