实时剪切波弹性成像在甲状腺实性结节良恶性鉴别诊断中的临床应用

Clinical application of real-time shear wave elastography in diagnosis of benign and malignant thyroid solid nodules

目的探讨实时剪切波弹性成像在甲状腺实性结节良恶性鉴别诊断中的应用价值。方法应用实时剪切波弹性成像技术对83例患者共113个甲状腺实性结节测量杨氏模量值，与手术病理结果进行对照，绘制R0c曲线图，获得区分甲状腺结节良恶性的杨氏模量临界值。结果①良性组杨氏模量值为（23．57±9．35）kPa，恶性组为（43．73±19．82）kPa，两者差异有统计学意义（t=6．31，P=0．00）。②通过ROC曲线确定良、恶性结节杨氏模量值的临界点为27．49kPa，其敏感性为93．2％，特异性为81．2％，准确性为85．8％，ROC曲线下面积为0．91。结论实时剪切波弹性成像技术可对甲状腺结节良恶性作出定量诊断，为鉴别甲状腺结节的良恶性提供了一种新的方法。

Objective To evaluate the clinical value ot Young＇s modulus by supersonic shear wave elastography （SWE） in differential diagnosis of thyroid solid nodlules. Methods Eighty-three patients with 113 solid nodules were examined by SWE. All the nodules were confirmed by pathology. According to Young＇s modulus, a receiver operating characteristic （ROC） curve was drawn,and it used to identify the value of optimal operating point for differential diagnosis of thyroid nodules. Results （1） The mean of Young＇s modulus of benign nodules was （23.57 ± 9.35）kPa, which was significantly different from the valve of malignant nodules（43.73 ± 19.82）kPa （t = 6.31, P = 0.00）. （2）It showed that the optimal operating point of ROC curve as 27.49, with high sensitivity（93.2%）, specificity（81.2%） and accuracy （85.8%）. The area under ROC curve was 0.91. Conclusions SWE is a newly quantitative technique of ultrasonography,which is helpful to identify and distinguish in the differential diagnosis of thyroid nodules.