结节性甲状腺肿伴纤维化与甲状腺乳头状癌的超声应变弹性成像定量分析

Quantitative analysis of ultrasound strain elastography in nodular goiter complicating fibrosis and papillary thyroid carcinoma

目的探讨实时组织弹性成像(RTE)技术的组织弥散定量分析对结节性甲状腺肿伴纤维化与甲状腺乳头状癌的鉴别诊断价值。方法对常规超声检查中可疑恶性的105例患者(107个结节)进行应变弹性成像检查,获得11个组织弥散定量分析参数。依据病理结果选取结节性甲状腺肿伴纤维化为一组,甲状腺乳头状癌为一组,对两组间11个参数进行比较分析。结果两组间应变均值(MEAN)、标准偏差(SD)、蓝色区域面积(%AREA)、对比度(CONT)、均等性(ENT)、杂乱度(IDM)、一致性(ASM)7个参数差异均有统计学意义(P<0.05)。将7个组织弥散定量分析参数绘制ROC曲线,以%AREA及MEAN 2个参数诊断价值最高,曲线下面积分别为0.779及0.720,诊断临界值为97.12%及28.61%,其灵敏度、特异度分别为88.9%和82.4%、60.3%和66.7%。结论组织弥散定量分析对结节性甲状腺肿伴纤维化与甲状腺乳头状癌的鉴别诊断有参考价值,以%AREA及MEAN价值最高。

Objective To explore the reference value of tissue diffusion quantitative analysis by real-time tissue elastography(RTE)for differentiation diagnosis of nodular goiter complicating fibrosis and papillary thyroid carcinoma.Methods One hundred and seven nodules in 105 patients with suspected malignancy conducted the strain elastography and 11 parameters for tissue diffusion quantitative analysis were obtained.According to the pathological results,all the nodules were divided into the nodular goiter complicating fibrosis group and papillary carcinoma group.The 11 parameters were compared between the two groups.Results There were statistically significant differences in 7 parameters of the average relative strain value(MEAN),standard deviation(SD),area ratio of low-strain region(%AREA),contrast(CONT),entropy(ENT),inverse difference moment(IDM)and angular second moment(ASM)between the two groups(P<0.05).The ROC curves were drawn by these 7 tissue diffusion quantitative analysis parameters.The diagnostic values of%AREA and MEAN were the highest,the areas under the curve(AUC)of which were 0.779 and 0.720 respectively,and the diagnostic cut-off values were 97.12%and 28.61%respectively,their sensitivities and specificities were 88.9%and 82.4%,and 60.3%and 66.7%respectively.Conclusion The tissue diffusion quantitative analysis software of RTE technique has the reference value for differential diagnosing nodular goiter complicating fibrosis and papillary carcinoma,the values of%AREA and MEAN are the highest.