剪切波弹性成像定量参数预测甲状腺乳头状癌颈部淋巴结转移的价值  

Value of quantitative parameters of shear wave elastography in predicting cervical lymph node metastasis in papillary thyroid carcinoma

作　　者：苏晓妮 曹军英 蒋南 孙健 李守超 张萌[3] Su Xiaoni;Cao Junying;Jiang Nan;Sun Jian;Li Shouchao;Zhang Meng(Department of Ultrasound Diagnosis,General Hospital of Northern Theater Command,Shenyang 110016 China;Jinzhou Medical University Northern Theater General Hospital Postgraduate Training Base,Shenyang 110016,China;Dalian Medical University Northern Theater General Hospital Postgraduate Training Base,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声诊断科,沈阳110016 [2]锦州医科大学北部战区总医院研究生培养基地,沈阳110016 [3]大连医科大学北部战区总医院研究生培养基地,沈阳110016

出　　处：《中国临床实用医学》2022年第3期7-10,共4页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目(2020JH2/10300122);沈阳市科技计划项目(20-205-4-058)。

摘　　要：目的探讨利用剪切波弹性成像(SWE)定量参数预测甲状腺乳头状癌(PTC)颈部淋巴结转移的应用价值。方法本研究为回顾性研究,选取2021年3月至2022年3月北部战区总医院收治的147例接受PTC及颈部淋巴结切除手术且经超声诊断科检查的患者,男63例,女84例,年龄(45.76±2.72)岁,年龄范围为32~55岁。所有患者均行SWE检查并接受手术,按照术后病理情况是否存在淋巴结转移,分为转移组(n=71)与未转移组(n=76)。比较两组患者淋巴结定量资料,记录弹性杨氏模量最大值(Emax)及最小值(Emin);绘制受试者工作特征(ROC)曲线,获得Emax与Emin的弹性杨氏模量值最佳截断值,以截断值诊断PTC颈部淋巴结是否存在转移,并根据ROC曲线下面积评价Emax与Emin对PTC颈部淋巴结是否转移的诊断价值。结果转移组患者的Emax[233.71(231.21,235.47)kPa]、Emin[43.23(41.56,45.13)kPa]均高于未转移组[60.47(59.69,61.65)kPa、1.37(1.30,1.51)kPa],差异有统计学意义(P<0.05)。当弹性杨氏模量值Emax截断值为214.32 kPa时,ROC曲线下面积为0.976,灵敏度为95.8%,特异度为97.4%,结果显示,PTC颈部淋巴结转移与弹性模量值Emax、Emin值有显著关系,差异有统计学意义(P<0.05)。结论SWE定量参数可以显著提高预测PTC淋巴结转移情况的准确性。Objective To evaluate the value of shear wave elastography(SWE)in predicting cervical lymph node metastasis in papillary thyroid carcinoma(PTC).Methods This study was a retrospective study,147 patients who underwent PTC and neck lymphadenectomy were examined by ultrasonography of General Hospital of Northern Theater Command from March 2021 to March 2022,the age was(45.76±2.72)years old,ranging from 32 to 55 years old.All patients were examined by SWE and underwent surgery.According to the pathological condition after surgery,they were divided into metastasis group(n=71)and non-metastasis group(n=76).The quantitative data of lymph nodes were compared between the two groups,and the maximum elastic Young′s modulus(Emax)and minimum elastic Young′s modulus(Emin)were recorded,and the receiver operating characteristic(ROC)curve were drawn to obtain the best truncation values of Emax and Emin′s elastic Young′s modulus,the cervical lymph node metastasis of PTC was diagnosed by cut-off value,and the value of Emax and Emin were evaluated according to the area under ROC curve.Results Emax[233.71(231.21,235.47)kPa]and Emin[43.23(41.56,45.13)kPa]in the metastasis group were higher than those in the non-metastasis group[60.47(59.69,61.65)kPa、1.37(1.30,1.51)kPa],the differences were statistically significant(P<0.05).When the elastic Young′s modulus was 214.32 kPa,the area under the ROC curve was 0.976,the sensitivity was 95.8%,and the specificity was 97.4%,the results showed that there was a significant correlation between PTC cervical lymph node metastasis and elastic modulus values Emax and Emin,the difference was statistically significant(P<0.05).Conclusions The SWE quantitative parameters can significantly improve the accuracy of predicting lymph node metastasis in PTC.

关 键 词：剪切波弹性成像 超声 甲状腺乳头状癌 淋巴结转移 弹性杨氏模量 

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]