实时剪切波弹性成像超声对甲状腺良恶性结节的诊断及其病理特征分析

Diagnosis and pathological characteristics of benign and malignant thyroid nodules by real-time shear wave elastography

目的探讨实时剪切波弹性成像超声(SWE)对甲状腺良恶性结节的诊断及其病理特征。方法回顾性选取2015年1月至2017年11月海南省人民医院收治的甲状腺良恶性结节患者90例,手术之后所有病灶均进行活检送病理检查,依据手术病理结果将患者分为良性组以及恶性组。对比两组患者SWE参数及其同病理特征之间的关系。结果恶性结节的SWE参数测量杨氏模量显著高于良性结节(P<0.05);良性结节中微小钙化者杨氏模量值明显高于无钙化者(P<0.05);良恶性结节当中结节位置以及是否存在囊性变对杨氏模量无显著差异(P>0.05);恶性结节粗大钙化结节同微小钙化、无钙化的杨氏模量对比无显著差异(P>0.05)。结论 SEW能够独立实时检测得甲状腺组织当中的杨氏模量,能够定量反映患者的结节硬度,从而有效鉴别良恶性,为患者的临床治疗提供可靠指导。

Objective To investigate the diagnosis and pathological features of real-time shear wave elastography（SWE） for benign and malignant thyroid nodules. Methods A retrospective study of 90 patients with benign and malignant thyroid nodules admitted to our hospital from January 2015 to November 2017 was performed. All the lesions were biopsied for pathological examination. The patients were divided into benign group and malignant group according to the pathological results. The relationship between SWE parameters and their pathological features was compared between the two groups. Results The SWE parameters of malignant nodules were significantly higher than those of benign nodules（P〈0. 05）. The Young＇s modulus of the microcalcifications in benign nodules was significantly higher than that of non-calcified patients（P〈0. 05）. There was no significant difference in the nodular position between the benign and malignant nodules and the presence or absence of cystic changes（P〉0. 05）. There was no significant difference between the coarse calcified nodules of malignant nodules and the Young＇s modulus of microcalcification and calcification（P〉0. 05）. Conclusion SEW can detect the Young＇s modulus in thyroid tissue independently and in real time,and can quantitatively reflect the patient＇s nodular stiffness,so as to effectively identify benign and malignant,and provide reliable guidance for clinical treatment of patients.