常规超声与声触诊组织量化技术诊断甲状腺结节的临床价值对比研究

Comparative analysis of clinical value of conventional ultrasound and virtual touch tissues quantification in diagnosis of thyroid nodules

目的探讨常规超声与声触诊组织量化技术诊断甲状腺结节的临床价值对比研究。方法应用常规超声检查方法及VTQ技术对2013年6月~2015年8月在广州市番禺区石碁人民医院就诊并超声科检查的750例患者共752个甲状腺结节进行检测评估,并对照病理及细胞穿刺学检查结果,根据受试者工作特征（ROC）曲线及结节内剪切波速度（SWV）诊断甲状腺结节良恶性的敏感性和特异性来对比两者的诊断价值。结果以病理检查为金标准,常规超声诊断甲状腺结节恶性敏感性、特异性、正确率分别为82.4%、76.7%、79.8%。甲状腺恶性结节SWV值2.12~9.00m/s,平均（4.55±2.20）m/s,良性结节SWV值1.03~2.68m/s,平均（2.03±0.36）m/s;甲状腺恶性结节SWV高于良性结节。当SWV截值=2.45m/s,VTQ诊断甲状腺结节恶性的敏感性、特异性、正确率分别为86.8%、84.8%、85.0%。对于诊断甲状腺恶性结节的ROC曲线下面积,常规超声为0.792,与VTQ相比明显较低（VTQ为0.906）,差异有统计学意义（Z=5.02,P〈0.05）。结论VTQ技术在甲状腺结节良恶性鉴别诊断效能高于常规超声。

Objective To explore comparative analysis of clinical value of conventional ultrasound and virtual touch tissues quantification（VTQ） in diagnosis of thyroid nodules. Methods 750 patients（752 thyroid nodules） receiving examinations in department of ultrasound in Shiqi People＇s Hospital of Panyu District, Guangzhou from June 2013 to August 2015 were received detection and evaluation of conventional ultrasound and VTQ. Results of pathology and cell punctures were compared. Sensitivity and specificity of benign and malignant thyroid nodules were diagnosed by receiver operating characteristic（ROC） curve and shear wave velocity（SWV） in nodules to compare diagnostic values of them. Results With pathological examination as the gold standard, sensitivity, specificity and accuracy of conventional ultrasound in diagnosis of malignant thyroid nodules were 82.4%, 76.7% and 79.8% respectively. SWV values ranges and average value of malignant thyroid nodules were 2.12 to 9.00m/s and（4.55±2.20）m/s respectively. SWV values ranges and average value of benign thyroid nodules were 1.03 to 2.68m/s, average（2.03±0.36）m/s respectively. SWV of malignant thyroid nodules was higher than that of benign thyroid nodules. When SWV cutoff value was 2.45m/s, sensitivity, specificity and accuracy of VTQ in diagnosis of malignant thyroid nodule were 86.8%, 84.8% and 85.0% respectively. For area under the ROC curve of malignant thyroid nodules, the conventional ultrasound was 0.792, significantly lower than VTQ（VTQ=0.906）. The difference was statistically significant（Z=5.02, P〈0.05）. Conclusion Diagnosis efficiency of VTQ in identifying benign and malignant thyroid nodules is higher than conventional ultrasound.