组织弥散定量分析技术在亚急性甲状腺炎病程分期中的应用价值

Application value of tissue dispersion quantitative analysis technique in different stages of SAT

目的探讨超声弹性成像组织弥散定量分析技术在亚急性甲状腺炎（SAT）病程分期中的作用。方法收集81例患者共144个病灶组为病例组，将其分为三个亚组：急性期组（Ⅰ组）、中期组（Ⅱ组）、恢复期组（Ⅲ组）；另收集59例健康志愿者作为对照组。对所有研究对象行常规超声及弹性超声检查，应用组织弥散定量分析软件对所有病灶感兴趣区进行分析，获得11个参数，将这些参数进行组间及亚组间比较分析，采用Spearman等级相关及多元线性回归分析其与SAT病程的相关性。结果11个参数中，复杂度（COMP）和相关性（CORR）在组间及亚组间比较差异均无统计学意义（均P〉0．05）。应变峰度直方图（KURT）和一致性（ASM）仅在亚组间差异无统计学意义（P〉0．05），其余参数在组间及亚组间差异均有统计学意义（均P〈0．01），且均与临床分期相关，其中以蓝色面积比例（％AREA）相关性最好（r=-0．881）。11个参数中仅％AREA进入回归方程，以％AREA绘制判断SAT分期的ROC曲线，曲线下面积为0．986、0．988。结论SAT患者受累甲状腺硬度增高，组织弥散定量分析技术能在一定程度上定量体现不同分期病灶硬度的分布特征，能为其诊断及临床治疗提供新的检测指标。

Objective To investigate the application value of the ultrasonic elastic tissue dispersion quantitative analysis technique in different stages of subacute thyroiditis （SAT）. Methods One hundred and forty-four SAT lesions detected from 81 patients were enrolled in the patient group. They were further divided into three subgroups, including acute group （group Ⅰ ）, medium group （group Ⅱ ） and recovery group （group Ⅲ ）. Another 59 healthy volunteers were collected as Control group. All the participants accepted conventional ultrasound and elastographic examinations. Eleven parameters were obtained by the tissue dispersion quantitative analysis software. These parameters were compared between groups and among subgroups by ANOVA. The correlation between all the parameters and the course of SAT were analyzed by Spearman and Multiple linear regression methods. Results Between groups and among subgroups, the complexity （COMP） and correlation （CORR） were not statistically different（all P 〉0.05）. Differences of kurtosis （KURT） and angular secon moment （ASM） among the three subgroups were not significant （all P 〉0.05）. Differences between groups and among subgroups were significantly different among the value of all the other seven indexes （all P d0.01）. Moreover, they were all correlated with the clinical staging, with the highest coefficient in area ration of low-strain region （ %AREA）（ r = -0. 881）. Regression model was constructed and only % AREA was selected into the regression equation. ROC curves were constructed to estimate the clinic value of % AREA in staging patients of SAT, the areas under ROC curves were 0.986（group Ⅰ vs group Ⅱ- Ⅲ ） respectively. Conclusions The tissue dispersion stiffness of thyroid in patients with SAT. and 0.988 （group Ⅰ - Ⅱvs group m） for %AREA, quantitative analysis technique is helpful in estimating the