甲状腺实性结节的声脉冲辐射力弹性成像诊断研究

摘要

目的 评估声脉冲辐射力弹性成像技术(ARFI)对甲状腺实性结节良恶性鉴别诊断价值.方法 对100例患者的118个实性结节行ARFI弹性成像声触诊组织成像(VTI)及声触诊组织定量(VTQ)两种技术检查,以VTI弹性分级≥IV级判断为恶性结节;VTQ中计算结节剪切波速度(SWV)平均值、结节周围非病灶组织平均值及两者的比值.结果 根据ROC曲线得出甲状腺良恶性结节SWV平均值及比值的最佳诊断界值分别为2.66m/s、1.21,曲线下面积(AUC)分别为0.780、0.762,敏感性、特异性、准确率分别为56%、89%、74%,69%、73%、71%;以VTI弹性分级≥IV级判断甲状腺实性结节良恶性具有显著性意义(P=0.000),其敏感性为78%,特异性为77%,准确率为77%.结论 ARFI技术定性及定量评价组织硬度,对甲状腺实性结节良恶性鉴别均有较高价值,两者结合应用对甲状腺实性结节的超声鉴别诊断有较大帮助.%Objective To evaluate the diagnostic value of acoustic radiation force impulse elastography(ARFI)for differential diagnosis of thyroid solid nodules.Methods 100 patients with 118 thyroid solid nodules were performed virtual touch tissue imaging(VTI)and virtual touch tissue quantitfi cation(VTQ)examination of ARFI. Elasticity of VTI≥IV grade level was considered malignant. Shear wave velocity(SWV) of nodule and non-nodule tissue were measured for 7 times. Average SWV of nodules and non-nodule tissue and the ratio of them were calculated. Results Optimum diagnosis cutoff of SWV averages and the ratios were 2.66m/s,1.21,AUC were 0.780,0.762 respectively according to ROC curve. Sensitivity, specifi city, accuracy rate of average SWV and the ratio were 56%,89%,74%, 69%,73%,71% separately.VTI≥IV grade level to differentiate benign and malignant thyroid nodules had signifi cant difference(P=0.000)with the sensitivity,specifi city and accuracy of VTI of 78%,77% and 77%.Conclusion s ARFI of qualitative and quantitative evaluation for tissue stiffness have a high value to differentiating thyroid solid nodules. Both Methods have theiradvantages and combined application would have greater value.