| 沙雨蒙,王兴田,王荣.声脉冲辐射力成像鉴别诊断桥本甲状腺炎背景下甲状腺实性小结节良恶性[J].中国介入影像与治疗学,2017,14(8):504-508 |
| 声脉冲辐射力成像鉴别诊断桥本甲状腺炎背景下甲状腺实性小结节良恶性 |
| Acoustic radiation force impulse imaging in differential diagnosis of small solid thyroid nodules coexisting with Hashimoto's thyroiditis |
| 投稿时间：2017-03-27 修订日期：2017-06-23 |
| DOI：10.13929/j.1672-8475.201703044 |
| 中文关键词: 超声检查 甲状腺结节 桥本甲状腺炎 声脉冲辐射力成像 |
| 英文关键词:Ultrasonography Thyroid nodules Hashimoto's thyroiditis Acoustic radiation force impulse imaging |
| 基金项目:徐州市科技项目（XZZD1337） |
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| 中文摘要: |
| 目的 探讨声脉冲辐射力成像（ARFI）鉴别诊断桥本甲状腺炎（HT）背景下甲状腺实性小结节良恶性的价值。方法 收集经病理证实的136例（155个）直径均≤ 1 cm的甲状腺实性小结节患者，分为HT背景组和正常背景组。所有患者术前均接受声触诊组织成像（VTI）及声触诊组织量化（VTQ）检查，通过VTI图像对不同背景下的小结节进行评分，计算结节VTI图像与灰阶图像面积比（VTI面积比）。以病理诊断为金标准，绘制ROC曲线，分析VTI面积比及剪切波速度（SWV）值预测不同背景下甲状腺恶性小结节的最佳截点和诊断效能。结果 正常背景组（58/71，81.69%）与HT背景组（27/42，64.29%）以VTI评分≥ 4分诊断甲状腺恶性结节的敏感度差异有统计学意义（P<0.05）；HT背景组及正常背景组中，恶性结节VTI面积比、SWV值均明显高于良性结节（P均<0.05）；HT背景组与正常背景组良性结节间、恶性结节间的VTI面积比、SWV值差异无统计学意义（P均>0.05）。以VTI面积比为1.41诊断HT背景组甲状腺恶性结节的敏感度为85.7%，特异度为88.9%，以SWV值为2.87 m/s诊断HT背景组甲状腺恶性结节的敏感度为85.7%，特异度为94.4%；以VTI面积比为1.40诊断正常背景组甲状腺恶性结节的敏感度为91.5%，特异度为95.8%，以SWV值为2.67 m/s诊断正常背景组甲状腺恶性结节的敏感度为88.7%，特异度为95.8%。结论 ARFI技术可通过直观VTI图像及客观SWV值反映HT背景下甲状腺实性小结节的硬度特征，有助于鉴别诊断HT背景下甲状腺小结节的良恶性。 |
| 英文摘要: |
| Objective To investigate the application value of acoustic radiation force impulse imaging (ARFI) in differential diagnosis of small solid thyroid nodules coexisting with Hashimoto's thyroiditis (HT). Methods A total of 136 patients with 155 small solid nodules (≤ 1 cm in diameter) confirmed by pathology were included. The small solid nodules were divided into HT group and normal group. All patients underwent virtual tissue imaging (VTI) and virtual touch tissue quantification (VTQ). The stiffness of small solid thyroid nodules in two groups was respectively scored based on VTI images, and the area ratios of nodules in VTI images to gray scale images were calculated. Taking pathological diagnosis as the gold standard, the ROC curve were performed to explore the optimal points and efficacy of area ratio and shear wave velocity (SWV) in the diagnosis of malignant nodules in two groups respectively. Results Regarding VTI score ≥ 4 as the diagnostic standard of malignant nodules, the sensitivity of HT group and normal group in diagnosis of malignant nodules had significant difference (64.29%[27/42] vs 81.69%[58/71], P<0.05). In two groups, the area ratio and SWV of malignant nodules were significantly higher than those of benign nodules (all P<0.05). The area ratio and SWV of thyroid benign nodules and malignant nodules had no significantly difference between two groups (all P>0.05). Taking 1.41 as the cutoff point of area ratio, the sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7% and 88.9%. Taking 2.87 m/s as the cutoff point of SWV, sensitivity and specificity in diagnosis of malignant nodules in HT group were 85.7% and 94.4%. Taking 1.40 as the cutoff point of area ratio, the sensitivity and specificity in diagnosis of malignant nodules in normal group were 91.5% and 95.8%. Taking 2.67 m/s as the cutoff point of SWV, the sensitivity and specificity in diagnosis of malignant nodules in normal group were 88.7% and 95.8%. Conclusion ARFI technology can evaluate the hardness of the small solid thyroid nodules through the intuitive VTI images and objective SWV values in HT, which is helpful in diagnosis of malignant nodules in HT backgroud. |
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