超声弹性分级与应变率比值鉴别诊断甲状腺微小结节

Ultrasound elastography score system and strain ratio in differential diagnosis of small thyroid nodules

目的评价超声弹性成像分级与弹性应变率比值法对直径≤1cm甲状腺微小结节的诊断价值。方法对手术病理证实的55例患者的72个直径≤1cm甲状腺结节的超声弹性图像进行分析,弹性分级分为4级,计算甲状腺组织与结节的弹性应变率比值。分别绘制弹性分级法及弹性应变率比值法的ROC曲线,评价其诊断价值。结果甲状腺良、恶性结节的超声弹性分级及弹性应变率比值差异均有统计学意义(P<0.001)。超声弹性分级及弹性应变率比值判断甲状腺占位性病灶的ROC曲线下面积分别为0.851、0.890(P=0.124)。甲状腺良、恶性小结节弹性应变率比值诊断界值为2.85。结论超声弹性分级法同弹性应变率比值法均能够有效地鉴别诊断甲状腺微小结节的性质。

Objective To observe the value of ultrasound elastography score system and strain ratio in discriminating thyroid lesions less than 1 cm in size. Methods Seventy-two thyroid small solid nodules in 55 patients selected for thyroid surgery underwent conventional ultrasound and elastographic evaluation. The images were classified into four elastography patterns. Thyroid tissue-to-nodule strain ratio was recorded as standard reference. The area under the curve （AUC） and the best cut-off point were both obtained using ROC curve analysis. Results There were significant differences in the elastography patterns and strain ratio between benign and malignant thyroid nodules （P〈0. 001）. The AUC of the elastography patterns and strain ratio was 0. 851 and 0. 890, respectively （P= 0. 124）. The best cut-off point of strain ratio was 2. 85 in detecting malignant thyroid nodules. Conclusion Elastography score system and strain ratio can assist in the differential diagnosis of small thyroid nodules.