超声弹性成像半定量评价甲状腺占位性病变的价值探讨

Value of ultrasonic elastography in semiquantitative evaluation of thyroid nodules by ultrasound

目的探讨弹性应变率比值对甲状腺占位性病变良恶性的鉴别诊断价值。方法对98例患者的129个病灶行甲状腺超声弹性成像检查,测量病灶与周围同层正常甲状腺组织的弹性应变率比值;以病理诊断为金标准,采用受试者工作特征(ROC)曲线确定弹性应变率比值的最佳临界值。结果恶性组平均应变率比值为8.08,良性组为2.14,两组比较差异有统计学意义(P<0.001)。通过ROC曲线确定的弹性应变率比值诊断甲状腺占位性病变良恶性的临界值为4.095;其诊断的敏感性为81.0%,特异性91.7%,准确性89.9%。结论超声弹性应变率比值可以用来初步评估甲状腺占位性病变的良恶性,为甲状腺占位性病变的初步判断提供了一项新的半定量诊断指标。

Objective To explore the differential diagnostic value of elasticity straining ratios in malignant and benign thyroid nodules. Methods One hundred and twenty-nine lesions in 98 patients were examined by ultrasonic elastography, and the elasticity straining ratios of thyroid tissue in lesions and normal peripheral layer were measured. The pathological results were used as gold standard, the best critical value of elasticity straining ratios was confirmed by receiver operating characteristic （ROC） curve. Results The mean strain ratio in malignant group and benign group were 8.08 and 2.14, reapeetively. There was significant difference of elasticity straining ratios between malignant group and benign group （ P 〈 0. 001 ）. The critical value of elasticity straining ratios confirmed by ROC curve was 4. 095 for diagnosing malignant and benign lesions. The sensitivity, specificity and accuracy were 81.0% , 91.7% , 89.9% , respectively. Conclusion Strain ratio of ultrasonic elastography can primarily assess the malignant and benign lesions of thyroid nodules, and it provides a new semiquantitative diagnostic index.