声触诊组织量化技术对甲状腺结节的鉴别诊断价值

Diagnostic value of virtual touch tissue quantification in diacriminating thyroid benign and malignant nodule

目的探讨声触诊组织量化（virtual touch tissues quantification，VTQ）技术鉴别甲状腺良恶性结节的可行性和应用价值。方法应用VTQ技术对265例患者共275个可疑恶性的甲状腺结节进行检测，评价观察者内剪切波速度（shearwavevelocity，swV）的重复性；对照病理及穿刺细胞学结果，根据ROC曲线确定SwV诊断甲状腺癌的敏感性和特异性，并且比较良恶性结节的swV。结果甲状腺结节观察者内的swV测值重复性好（ICC〉0．75）；甲状腺恶性结节swV高于良性结节，差异有统计学意义（3．13m／s对2．07m／s，Z=-12．17，PdO．05），由ROc曲线可知，当swV截值=2．35m／s（曲线下最大面积=0．946）时，其预测甲状腺恶性结节的敏感性和特异性分别为91．1％和82．3％。结论VTQ技术具有无创、简便及重复性高的特点，有助于甲状腺良恶性结节的鉴别。

Objective To explore the value of virtual touch tissue quantification （VTQ） in the differential diagnosis of thyroid solid lesions. Methods A total of 265 patients with 275 thyroid nodules were examined by means of VTQ technique. The inter-observer reproducibility of shear wave velocities （SWV） were analyzed with Bland-Altman plot. Compared with the pathologic findings or fine needle aspiration cytology diagnosis, SWV of thyroid nodules were compared by Nonparametric test. Results All VTQ value measured in thyroid nodules were with good reproducibility （ICC〉0.75）. The SWV value of malignant nodules were significantly higher than benign nodules（3.13 m/s vs 2.07 m/s, Z = - 12.17, P 0.05）. According to the area under the ROC curve, The sensitivity and specificity of SWV （area under ROC = 0. 946,cut-off value = 2.35 m/s） in predicting thyroid cancer was 91.1% and 82.3% respectively. Conclusions It was stable for VTQ technique applying in thyroid leisions,which was a new quantitative and helpful method in evaluating benign and malignant thyroid nodules and therefore had good diagnostic value in clinical applications.