声触诊组织定量技术鉴别诊断甲状腺良恶性结节

Virtual touch tissue quantification in differential diagnosis of benign and malignant thyroid nodules

目的探讨声触诊组织定量成像（VTQ）鉴别诊断甲状腺良恶性结节的价值。方法收集48例经手术或穿刺病理证实的甲状腺结节患者,均行常规超声及VTQ检查,获得结节及结节周围组织的剪切波速度（SWV）,采用ROC曲线进行统计学分析。结果良性结节及其周围组织的SWV分别为（2.05±0.25）m/s[95%可信区间（CI）：1.95-2.15m/s]、（1.78±0.26）m/s（95%CI：1.68-1.88 m/s）,恶性结节及其周围组织SWV分别为（3.57±1.29）m/s（95%CI：3.06-4.09m/s）、（1.85±0.29）m/s（95%CI：1.73-1.96m/s）。良性结节与恶性结节、良性结节与其周围组织、恶性结节与其周围组织间SWV的差异均有统计学意义（P均〈0.001）,而良性结节周围组织与恶性结节周围组织间SWV的差异无统计学意义（P=0.5006）。应用SWV诊断甲状腺恶性结节的ROC曲线下面积为0.9927,截断值为2.416m/s,敏感度、特异度、阳性预测值、阴性预测值、阳性似然比及阴性似然比分别为88.89%（24/27）、96.43%（27/28）、96.00%（24/25）、90.00%（27/30）、24.89及0.12。结论 VTQ检查能够通过SWV值反映出结节及其周围组织的硬度,在对甲状腺结节良恶性的鉴别诊断中具有重要价值。

Objective To explore the value of virtual touch tissue quantification（VTQ）imaging in differentiating diagnosis of benign and malignant thyroid nodules.Methods Totally 48 patients with 55 thyroid nodules confirmed by surgery or biopsy pathology were collected and underwent convention ultrasound and VTQ,and then the shear wave velocity（SWV）of the nodules and tissue surounding nodule were acquired.The ROC curve were performed to assess the diagnostic value.Results The SWV value of benign nodule（BN）and tissue surounding benign nodule（TSBN）was（2.05±0.25）m/s（95%CI 1.95—2.15m/s）,（1.78±0.26）m/s（95%CI 1.68—1.88m/s）,respectively.Malignant nodule（MN）and tissue surrounding malignant nodule（TSMN）was（3.57±1.29）m/s（95%CI 3.06—4.09m/s）,（1.85±0.29）m/s（95%CI1.73—1.96m/s）,respectively.The differences of SWV between BN and MN,MN and TSMN,BN and TSBN,were statistically significative（all P〈0.001）,while that between TSBN and TSMN had no statistical significance（P=0.5006）.The area under ROC curve was 0.9927,with a cut-off value of 2.416m/s,the sensitivity,specificity,positive predictive value,negative predictive value,＋likelihood ratio,—likelihood ratio for the diagnosis of malignant thyroid nodules was88.89%（24/27）,96.43%（27/28）,96.00%（24/25）,90.00%（27/30）,24.89,0.12,respectively.Conclusion VTQ provides the stiffness of nodules and healthy thyroid tissue by using SWV,which could play an important value in differentiating benign and malignant thyroid nodules.