声触诊组织量化与声触诊组织定量技术对甲状腺结节良恶性的鉴别诊断

Study on the diagnostic values of virtual touch tissue imaging quantification and virtual touch tissue quantification techniques in differentiating thyroid benign and malignant nodules

目的比较声触诊组织量化(VTIQ)与声触诊组织定量(VTQ)技术在甲状腺结节良恶性鉴别诊断中的应用价值。方法选取2016年8月至11月在哈尔滨医科大学附属第一医院就诊并经手术病理证实的182例患者共186个甲状腺结节,行常规超声与VTIQ及VTQ检查。测量良恶性结节的剪切波速度(SWV),采用t检验比较良性结节与恶性结节之间SWV测值的差异。绘制受试者工作特征(ROC)曲线,计算VTIQ与VTQ技术鉴别诊断甲状腺良恶性结节的敏感度、特异度、准确性、阳性预测值和阴性预测值。采用Z检验分析曲线下面积(AUC)进行组间比较,比较两种弹性技术对甲状腺结节的诊断效能。结果 186个甲状腺结节中,82个结节为良性,104个结节为恶性。VTIQ SWV平均值、VTIQ SWV中位数、VTQ SWV平均值、VTQ SWV中位数测量甲状腺结节良恶性曲线下面积分别为0.848、0.790、0.759、0.717。在VTIQ与VTQ技术中,SWV平均值均较SWV中位数诊断效能高,差异均有统计学意义(VTIQ技术:Z=2.104,P=0.0354;VTQ技术:Z=2.190,P=0.0285),VTIQ SWV平均值与VTQ SWV平均值鉴别甲状腺结节良恶性的比较,差异有统计学意义(Z=2.115,P=0.0344),以VTIQ SWV平均值诊断效能最佳,鉴别结节良恶性的截断值为2.91 cm/s,敏感度、特异度、准确性、阳性预测值、阴性预测值分别为72.12%、87.80%、79.03%、88.24%、71.29%。结论 VTQ与VTIQ弹性成像技术对甲状腺结节良恶性的鉴别诊断均有较好的应用价值。VTIQ SWV平均值较VTQ SWV平均值对良恶性的鉴别诊断有一定的优势。

Objective To compare the diagnostic performances of two elastography techniques,virtual touch tissue imaging quantification(VTIQ)and virtual touch tissue quantification(VTQ),indifferentiating between benign and malignant thyroid nodules.Methods A total of182patients with186nodules evaluated by VTQ and VTIQ were enrolled in this study.Shear wave velocities(SWV)of benign and malignant nodules were measured and compared between different groups by t test.The receiver operating characteristic curve(ROC)was used to assess the value of VTIQ and VTQ in differentiating benign and malignant nodules.And the sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of VTIQ and VTQ were calculated.According to areas under the curve(AUC),the diagnostic values of these two elastography techniques for thyroid nodules′qualitative diagnosis were compared by Z test.Results In pathology,104thyroid nodules were benign and82were malignant.AUC of VTIQ SWV mean,VTIQ SWV median,VTQ SWV mean,VTQ SWV median were0.848,0.790,0.759,0.717,respectively.In the VTIQ and VTQ techniques,the SWV mean had higher diagnostic efficacy than the SWV median(VTIQ techniques:Z=2.104,P=0.0354;VTQ techniques:Z=2.190,P=0.0285).There were statistical differences in the diagnosis performance between VTIQ SWV mean and VTQ SWV mean(Z=2.115,P=0.0344).The VTIQ SWV mean value in the nodule had the best diagnostic value in comparison with other SWV values.The cut-off value of VTIQ SWV mean was2.91m/s.According to ROC curve analysis,the sensitivity,specificity,accuracy,PPV and NPV for VTIQ SWV mean were72.12%,87.80%,79.03%,88.24%,71.29%,respectively.Conclusions The results demonstrated that VTQ and VTIQ have good diagnostic performance on distinguishing malignant from benign thyroid nodules.VTIQ SWV mean shows a better diagnostic performance than VTQ SWV mean.