声触诊组织量化鉴别诊断甲状腺实性结节的良恶性

Virtual touch tissue quantification in differential diagnosis of solid thyroid nodules

目的探讨声触诊组织量化技术(VTQ)在甲状腺实性结节良恶性鉴别诊断中的应用价值。方法采用VTQ技术测量经病理证实的101例患者共129个甲状腺实性结节及周边甲状腺组织剪切波速度(SWV),以病理诊断为金标准,绘制SWV诊断甲状腺实性恶性结节的ROC曲线,获得结节SWV诊断恶性结节的最佳截点。结果甲状腺实性恶性结节的SWV[(3.15±1.91)m/s]大于良性结节[(2.06±0.54)m/s,P<0.01]。以SWV=2.43m/s为截点诊断甲状腺实性恶性结节的敏感度、特异度分别为67.80%(40/59)、91.43%(64/70)。甲状腺恶性结节与周边甲状腺组织SWV比值(1.56±0.86)大于良性结节与周边甲状腺组织SWV比值(1.00±0.29,P<0.01)。结论 VTQ技术可量化甲状腺结节硬度,对鉴别诊断甲状腺实性结节具有较高的应用价值。

Objective To investigate the applicative value of virtual touch tissue quantification（VTQ）in the differential diagnosis of solid thyroid nodules.Methods Totally 129 solid thyroid nodules of 101 patients and surrounding thyroid tissue were measured by VTQ technology.Shear wave velocity（SWV）was obtained.With pathological diagnosis as the gold standard,ROC curve of the SWV in the diagnosis of thyroid solid malignant nodules was sketched so as to explore the optimal cut-off point of SWV in diagnosis of malignant nodules.Results The malignant solid thyroid nodules had higher SWV（[3.15±1.91]m/s）than that of the benign nodules（[2.06±0.54]m/s,P〈0.01）.The SWV of 2.43m/s in diagnosis of thyroid malignant nodules was designated as the cut-off point,with a sensitivity of 67.80%（40/59）,specificity of 91.43%（64/70）.The SWV ratio between malignant thyroid nodules and surrounding thyroid tissue（1.56±0.86）was higher than that of benign thyroid nodules（1.00±0.29）,which was statistical difference（P〈0.01）.Conclusion The VTQ technique is able to quantify thyroid nodule hardness,which has great applicative value in the differential diagnosis of thyroid solid nodules.