声辐射力脉冲成像技术在甲状腺占位性病变中的研究

Application of acoustic radiation force impulse in the differentiation of thyroid benign and malignant tumors

目的:探讨声辐射力脉冲成像技术(ARFI)对甲状腺占位性良恶性病变鉴别诊断的临床价值。方法:应用ARFI技术对75例(共93个病灶)甲状腺占位性病变患者进行检查,所有病例分为恶性占位组、良性占位组,与术后病理结果对照,并分别与正常甲状腺组织剪切波速进行对比分析。结果:ARFI技术检测的甲状腺恶性占位病变与甲状腺良性占位病变组比较,剪切波速差异有显著性意义(P<0.001);甲状腺恶性占位病变组与甲状腺正常组剪切波速比较差异有极显著性(P<0.001);甲状腺良性占位与甲状腺正常组剪切波速比较差异具有显著性(P<0.017)。以>3.0m/s作为甲状腺恶性占位的诊断标准,ARFI鉴别甲状腺良恶性占位的敏感性为92.1%,特异性为85.5%,约登指数为0.78。结论:ARFI技术可以直观地显示甲状腺肿瘤的硬度,有效评价肿瘤组织的弹性变化,为甲状腺脏良、恶性病变的早期鉴别诊断提供更多的信息和依据。

Objective To investigate the clinical value of acoustic radiation force impulse （ARFI） technology in the differentiation of thyroid benign and malignant tumors. Methods 75 patients with 93 focuses were enrolled in this study and received ARFI examination. All the patients were divided into malignant and benign groups, and the results of ARFI were compared to the postoperative pathological results, with normal thyroid tissue as control group. Results The difference of the shear wave velocity was significant between malignant and benign groups （P 〈 0.001 ）, between malignant and normal groups （P 〈 0.001）, and between benign and normal groups （P 〈 0.017）. For diagnosing malignant thyroid tumors, the sensitivity, specificity, and Youden index of the cut-off of 3.0m/s were 92.1%, 85.5%, and 0.78. Conclusions ARFI technology can visually display the thyroid tumor hardness, effectively evaluate the elasticity change of thyroid tumor tissue, and is a reliable method for predicting thyroid benign and malignant tumors.