PDUS半定量分级、SWE对甲状腺结节的定性诊断价值及其与组织病理结构的关联关系分析  

Value of PDUS Quantitative Grading and SWE in the Qualitative Diagnosis of Thyroid Nodules and Their Correlation with Histopathological Structure

作　　者：李光玲 张兰[2] 寇晋丽 李心娜 王位 林云 LI Guang-ling;ZHANG Lan;KOU Jin-li;LI Xin-na;WANG Wei;LIN Yun(Department of Medical Technique Support,Jingzhong Medical District,General Hospital of Chinese People's Liberation Army,Beijing,100120,China;Department of Outpatientt,Jingzhong Medical District,General Hospital of Chinese People's Liberation Army,Beijing,100120,China;Department of Comprehensive Surgery,Jingzhong Medical District,General Hospital of Chinese People's Liberation Army,Beijing,100120,China)

机构地区：[1]中国人民解放军总医院京中医疗区医技保障科,北京100120 [2]中国人民解放军总医院京中医疗区门诊部,北京100120 [3]中国人民解放军总医院京中医疗区综合外科,北京100120

出　　处：《现代生物医学进展》2024年第22期4271-4274,共4页Progress in Modern Biomedicine

基　　金：国家卫生健康委"十四五"规划全国重点课题(YYWS4272)。

摘　　要：目的:探讨分析能量多普勒超声(PDUS)半定量分级、剪切波弹性成像(SWE)对甲状腺结节的定性诊断价值,并探讨其与组织病理结构的关联关系。方法:170例甲状腺结节患者均行PDUS和SWE检查。以病理结果为金标准,分析PDUS半定量分级、SWE单独及联合应用检查对甲状腺结节良恶性的定性诊断效能。并根据术后病理组织结构中实质及间质的排列分布情况进行分析,以多因素Logistic回归分析PDUS半定量分级、SWE结果和组织病理结构学的关联影响关系。结果:PDUS联合SWE诊断甲状腺结节良恶性的Kappa值、灵敏度、特异度、准确度均明显高于两法单独诊断。多因素Logistic回归分析发现,各组织学特征与PDUS半定量分级关联程度依次为:广泛纤维化>乳头结构>微滤泡结构;各组织学特征与SWE关联程度依次为:广泛纤维化>乳头结构>炎性细胞浸润>局部纤维化。结论:PDUS半定量分级联合SWE可显著提高甲状腺结节良恶性的定性诊断价值,且间质广泛纤维化是影响PDUS和SWE检测甲状腺结节的最显著组织病理因素。Objective:To investigate the diagnostic value of power doppler ultrasound(PDUS)semi quantitative grading and shear wave elastography(SWE)in the qualitative diagnosis of thyroid nodules,and to explore its correlation with histopathological structure.Methods:A total of 170 patients with thyroid nodules underwent PDUS and SWE examinations,the pathological results were used as the gold standard to analyze the qualitative diagnostic efficacy of PDUS semi quantitative grading,SWE alone and combined examination for benign and malignant thyroid nodules.According to the distribution of parenchyma and stroma in postoperative pathological tissue structure,the relationship between PDUS semi quantitative grading,SWE results and histopathological structure was analyzed by multivariate Logistic regression analysis.Results:The Kappa value,sensitivity,specificity and accuracy of PDUS combined with SWE in the diagnosis of benign and malignant thyroid nodules were significantly higher than those of the two methods alone.Multivariate logistic regression analysis showed that the correlation between histological features and PDUS semi quantitative grading was as follows:extensive fibrosis>papillary structure>microfollicular structure,and the correlation between various histological features and SWE was as follows:extensive fibrosis>papillary structure>inflammatory cell infiltration>local fibrosis.Conclusion:PDUS semi quantitative grading combined with SWE can significantly improve the qualitative diagnostic value of benign and malignant thyroid nodules,and extensive interstitial fibrosis is the most significant histopathological factor affecting the detection of thyroid nodules by PDUS and SWE.

关 键 词：能量多普勒超声 半定量分级 剪切波弹性成像 甲状腺结节 定性诊断 组织病理结构 关联关系 

分 类 号：R581[医药卫生—内分泌]