天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (3): 319-322.doi: 10.11958/j.issn.0253-9896.2015.03.026

• 诊断技术 • 上一篇    下一篇

超声弹性成像与声辐射力脉冲弹性成像对甲状腺单发实性结节的诊断价值

杜婷婷， 李军， 夏东琴， 芦桂林   

  1. 石河子大学医学院第一附属医院 （邮编 832008）
  • 收稿日期:2014-07-22 修回日期:2014-10-15 出版日期:2015-03-15 发布日期:2015-03-15
  • 通讯作者: 芦桂林 E-mail:690821295@qq.com
  • 作者简介:杜婷婷 （1986）， 女， 硕士在读， 主要从事超声弹性成像研究

The diagnostic value of ultrasound elastography and acoustic radiation force impulse imaging in solitary solid thyroid nodule

DU Tingting， LI Jun， XIA Dongqin， LU Guilin#br#   

  1. Department of Ultrasonography, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China

  • Received:2014-07-22 Revised:2014-10-15 Published:2015-03-15 Online:2015-03-15
  • Contact: LU Guilin E-mail:690821295@qq.com

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摘要： 目的 评价超声弹性成像（UE）技术、 声辐射力脉冲弹性成像（ARFI）技术对常规超声图像中表现为甲状腺单发实性结节的良恶性鉴别诊断的价值。方法 选取 2013 年 12 月—2014 年 7 月石河子大学医学院第一附属医院甲状腺单发实性结节患者 100 例。对 100 个结节术前分别进行常规超声检查、 UE 检查及 ARFI 检查。均行甲状腺结节切除术， 并经术后病理证实。UE 选用弹性分级， ARFI 检测病灶组织的剪切波速度 （SWV）。以病理诊断作为金标准， 评价 3 种方法的诊断价值。根据本组甲状腺良、 恶性结节 SWV 值绘制 ROC 曲线。结果 曲线下面积（AUC）为 0.960， SWV 值最佳诊断点为 2.76。诊断甲状腺恶性单发实性结节， 常规超声、 UE 五级评分法以及 ARFI 法 SWV 值的灵敏度分别为 82.61%（19/23）、 82.61%（19/23）、 91.30%（21/23）， 特异度分别为 87.01%（67/77）、 88.31% （68/77）、 93.51%（72/77）， 阳性预测值分别为 65.52%（19/29）、 67.86%（19/28）、 80.77%（21/27）， 阴性预测值分别为 94.37%（67/71）、 94.44%（68/72）、 97.29%（71/73）。结论 ARFI 技术针对甲状腺恶性单发实性结节的良恶性鉴别诊断能力优于常规超声技术及 UE 技术， 值得临床应用推广。

关键词: 甲状腺结节, 超声检查, 弹性成像技术

Abstract: Objective To evaluate the diagnostic values of ultrasound elastography (UE) technology and acoustic radia⁃ tion force impulse (ARFI) technology in the differential diagnosis of benign and malignant single solid thyroid nodule showed by ultrasonography. Methods A total of 100 patients with solitary thyroid nodule diagnosed by the Affiliated Hospital, School of Medicine of Shihezi University in December 2013 to July 2014 were selected in this study. The routine ultrasound, UE examination and ARFI technology were used in patients before operation. All patients were performed operation for thy⁃ roid nodules and the diagnosis was confirmed by the pathologic results. A flexible classification method was used in UE. ARFI was used to detect shear wave velocity (SWV) of lesions. The diagnostic values of three methods were evaluated by the gold standard of pathologic results. ROC curves were plotted according to SWV values of benign and malignant thyroid nod⁃ ules. Results The area under the curve (ACU) was 0.960. The best cut-off value of SWV was 2.76 for diagnosis. The diag⁃ nostic sensitivities of malignant thyroid solid nodules were 82.61% (19/23), 82.61% (19/23) and 91.30% (21/23) for US, UE and ARFI, respectively. The diagnostic specificities were 87.01% (67/77), 88.31% (68/77) and 93.51% (72/77) respectively. And the positive predictive values (PPV) were 65.52% (19/29), 67.86% (19/28) and 80.77% (21/27) respectively； the negative predictive values (NPV) were 94.37% (67/71)， 94.44% (68/72) and 97.29% (71/73). Conclusion ARFI technology is superior to US and UE technology in predicting malignancy in solitary solid thyroid nodule, which is worth of clinical applica⁃ tion and promotion.

Key words: thyroid nodule, ultrasonography, elasticity imaging techniques