二维剪切波弹性成像联合SMI对甲状腺结节良恶性的诊断效能  

Diagnostic efficacy of two-dimensional shear wave elastography combined with SMI technology for benign and malignant thyroid nodules

作　　者：邓淑敏 张晓红 胡琼 Deng Shumin;Zhang Xiaohong;Hu Qiong(Xinyang Central Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市中心医院,河南信阳464000

出　　处：《临床心身疾病杂志》2025年第2期28-31,共4页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20200922)。

摘　　要：目的 评估二维剪切波弹性成像联合超微血管成像(SMI)在鉴别甲状腺结节良恶性方面的有效性。方法 回顾性选取97例甲状腺结节患者,以病理学结果为“金标准”,采用二维剪切波弹性成像收集最大弹性模量值(Emax),计算结节最大硬度与周围正常甲状腺组织硬度的比值(Eratio)。采用SMI对所有患者甲状腺结节良恶性进行判断,并绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)分析二维剪切波弹性成像联合SMI对恶性甲状腺结节的诊断效能。结果 97例甲状腺结节患者中,经病理证实恶性(甲状腺癌)患者51例(恶性组),良性患者46例(良性组)。恶性组患者的Emax、Eratio值高于良性组(P<0.01)。以病理学结果为“金标准”,SMI准确率为92.78%。ROC曲线分析结果显示,Emax、Eratio、SMI及三者联合对恶性甲状腺结节进行诊断的AUC分别为0.905、0.855、0.928、0.986,表明其对恶性甲状腺结节具有良好的诊断价值,且三者联合的诊断价值高于Emax、Eratio、SMI的单独诊断(Z=2.640、3.512、1.990,P=0.008、0.000、0.047)。结论 二维剪切波弹性成像、SMI对甲状腺结节良恶性均有良好的诊断效能,且二者联合的诊断效能更优。Objective To assess the effectiveness of two-dimensional shear wave elastography(2D-SWE)combined with superb microvascular imaging(SMI)in distinguishing benign and malignant thyroid nodules.Methods Ninety-seven patients with thyroid nodules were retrospectively selected,pathological results used as the‘gold standard’,the maximum Young's modulus(Emax)was collected using the 2D-SWE,and the ratio of the maximum hardness of nodules to the hardness of the surrounding normal thyroid tissue(Eratio)calculated.The benign and malignant thyroid nodules of all patients were judged using the SMI,the areas under the receiver operating characteristic(ROC)curve(AUC)used to analyze the diagnostic efficacy of 2D-SWE+SMI for malignant thyroid nodules.Results Of 97 thyroid nodules patients,51 were malignant(thyroid cancer,malignant group)pathologically confirmed,and 46 benign benign group.The Emax and Eratio value were higher in malignant than benign group(P<0.01).Using pathological results as the‘gold standard’,SMI accuracy rate was 92.78%.The ROC curve analysis results showed that the AUC of Emax,Eratio,SMI,and their combination in diagnosing malignant thyroid nodules were 0.905,0.855,0.928,and 0.986 respectively,which showed they had better diagnostic values for malignant thyroid nodules,and combined diagnostic value of the three is higher compared with single diagnosis(Z=2.640,3.512,1.990,P=0.008,0.000,0.047).Conclusion Both 2D-SWE and SMI have good diagnostic efficacy for benign and malignant thyroid nodules and the diagnostic efficacy of their combination is better.

关 键 词：甲状腺结节 二维剪切波弹性成像 超微血管成像 良恶性评估 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]