剪切波弹性成像联合MicroPure成像技术对TI-RADS 3、4结节的鉴别诊断价值

摘要

Objective To evaluate the value of shear wave elastography(SWE)combined with ultrasonic MicroPure ima-ging in differential diagnosis of category 3 or 4 nodules in thyroid imaging report and data system(TI-RADS). Methods 127 cases of patients with TI-RADS category 3 or 4 thyroid nodules were screened using conventional two-dimensional ultrasonography through assessing the border,aspect ratio and internal echo of the thyroid nodules,156 nodules in total. Every nodule underwent ultrasonic MicroPure imaging and SWE scanning sequentially to acquire Young modulus. The value of MicroPure imaging,SWE or the combi-nation of the two in the diagnosis of TI-RADS category 3 or 4 was compared,with all nodules verified by postoperative pathology or fine needle aspiration(FNA). Results ①The average Young modulus of benign and malignant thyroid nodules was(25. 18 ± 14. 64)kPa and(64. 58 ± 24. 69)kPa,respectively,with statistically significant between-group difference(P＜0. 05).②Areas un-der the ROC curve of ultrasonic MicroPure imaging and conventional two-dimensional ultrasonography in the detection of microcal-cification in the nodules were 0. 870 and 0. 577,respectively,the difference being statistically significant(p＜0. 05).③The sensi-tivity and accuracy of ultrasonic MicroPure imaging combined with SWE ( 92. 31% and 88. 46%) in differential diagnosis of TI-RADS category 3 or 4 nodules were both higher than those of conventional two-dimensional ultrasonography alone,the difference being statistically significant(P＜0 05). Conclusion The combination of SWE and MicroPure imaging on the basis of convention-al two-dimensional ultrasonography can improve the diagnostic accuracy of TI-RADS category 3 or 4 nodules,providing diagnostic basis for clinical treatment.%目的 评价剪切波弹性成像技术( SWE)联合超声MicroPure成像对甲状腺影像学报告及数据系统( TI-RADS)中3、4级结节的鉴别诊断价值.方法 运用常规二维超声观察甲状腺结节边界、纵横比、内部回声等情况筛选出TI-RADS 3、4级结节患者127例,共156例结节,并对每个结节依次行超声MicroPure成像、SWE扫查,获得杨氏模量值,比较超声Micropure成像、SWE及其二者联合应用对TI-RADS 3、4级结节的诊断价值.所有结节均经术后病理及细针穿刺抽吸(FNA)证实.结果 ①甲状腺良恶性结节平均杨氏模量值分别为(25.18 ±14.64)kPa、(64.58 ±24.69)kPa,二者间差异有统计学意义( P＜0. 05);②超声 Micropure成像与常规二维超声检测结节内微钙化的 ROC 曲线下面积分别为0. 870 和0. 577,差异有统计学意义(P＜0. 05);③超声Micropure成像与SWE联合应用对TI-RADS 3、4级结节鉴别诊断的敏感度(92. 31%)和准确度(88. 46%)均高于单独应用常规二维超声,且差异有统计学意义(P＜0. 05).结论 在常规二维超声的基础上联合应用SWE及超声MicroPure成像技术能够提高对TI-RADS3、4级结节诊断的准确度,为指导临床治疗提供依据.