实时剪切波弹性成像在甲状腺实性结节良恶性鉴别中的临床应用

The Clinical Application of Real-time Shear Wave Elastic Imaging in the Identification of Benign and Malignant Thyroid Nodules

目的:探讨分析实时剪切波弹性成像在甲状腺实性结节良恶性鉴别中的临床应用效果。方法:选取本院收治的57例甲状腺实性结节患者作为研究对象,对所有患者采用实时剪切波弹性成像技术进行检查,测量统计良恶性甲状腺结节的杨氏模量值,并与病理检查结果对比,通过绘制ROC曲线图获得区分甲状腺结节良恶性的杨氏模量值的最佳临界值。结果:经检测,57例患者共有74个甲状腺实性结节,其中54个为良性结节,20个为恶性结节。良性结节的杨氏模量平均值为(25.17±6.63)k Pa,恶性结节的杨氏模量平均值为(48.05±17.32)k Pa,明显高于良性结节,比较差异有统计学意义(P<0.05)。通过ROC曲线分析,发现区分甲状腺结节良恶性的杨氏模量最合适临界点为29 k Pa,此时ROC曲线下面积为0.913,测量的敏感性、特异性以及准确性分别为91.5%、83.4%、86.2%。结论:应用实时剪切波弹性成像技术能通过测量结节的弹性模量值对甲状腺结节的硬度进行定量分析,从而为鉴别良恶性结节提供新的诊断依据。

Objective:To investigate the clinical application of real-time shear wave elastography in differentiating benign and malignant solid thyroid nodules.Method:57 patients with solid thyroid nodules in our hospital were selected as study subjects and all patients were examined by real time shear wave elastography.The Young’s modulus value measure in benign and malignant thyroid nodules,and compared with pathologic examination results,through the plot of ROC for differentiating benign from malignancy in thyroid nodules of Young’s modulus value the best threshold.Result:There were 74 solid thyroid nodules in 57 patients.Among them,54 were benign nodules and 20 were malignant nodules.The average value of Young’s modulus of benign nodules was(25.17±6.63)kPa,and the mean value of Young’s modulus of malignant nodules was(48.05±17.32)kPa,significantly higher than that of benign nodules,the difference was statistically significant(P<0.05).By ROC curve analysis,found that the Young’s modulus of differentiating benign from malignancy in thyroid nodule is the most appropriate point for 29 kpa,the area under the ROC curve is 0.913,measurement sensitivity,specificity and accuracy were 91.5%,83.4%and 86.2%respectively.Conclusion:Application of real-time elastic shear wave imaging technology can by measuring the elastic modulus value of the nodules of thyroid nodule hardness in quantitative analysis,so as to provide new diagnostic basis for identification of benign and malignant nodules.