声触诊组织成像鉴别甲状腺实性结节良恶性的价值研究

Applicative value of virtual touch tissue imaging in differential diagnosis of benign or malignant lesion of solid thyroid nodules

目的探讨声触诊组织成像(VTI)技术在鉴别甲状腺实性结节良恶性中的应用价值。方法回顾性分析经病理证实的101例患者129例甲状腺实性结节的常规超声及VTI图像特征。通过对甲状腺实性结节VTI图像进行硬度评分,并计算结节VTI图像与灰阶图像面积比。以病理诊断为金标准,分别绘制VTI评分、面积比诊断甲状腺恶性结节的ROC曲线,找出VTI评分、面积比诊断恶性结节的最佳截点。结果以VTI评分4分为截点诊断甲状腺恶性结节的敏感性81.3%,特异性92.9%。甲状腺恶性结节VTI图像与灰阶图像面积比高于良性结节(1.49±0.25 vs 1.15±0.06,P<0.05),以面积比1.24为截点诊断甲状腺恶性结节的敏感性为91.5%,特异性为95.7%。结论甲状腺实性良恶性结节在VTI成像方面存在差异。VTI技术可以定性及定量反应结节的弹性硬度信息,对甲状腺实性结节的良恶性鉴别诊断具有较高的应用价值。

Objective To explore the clinical value of virtual touch tissue imaging(VTI)in the differential diagnosis of benign or malignant lesion of solid thyroid nodules.Methods The characteristics of image of routine ultrasound and virtual touch tissue imaging of 129 solid nodules in 101 patients those were pathologically confirmed were analyzed retrospectively.Based on VTI images of the nodules,the hardness of thyroid nodules was respectively scored,and the ratios of VTI images to gray scale image areas were calculated.The ROC curve of VTI scores and area ratios in diagnosis of thyroid malignant nodules were sketched and pathological diagnosis was set as the gold standard,so as to explore the optimal cut-off points in VTI scores,area ratios in the diagnosis of malignant nodules.Results When VTI score of 4 was determined as the cut-off point,the sensitivity and specificity of VTI in diagnosing thyroid cancer was 81.3%and 92.9%,respectively.Malignant thyroid nodules had higher ratio of VTI images to gray scale image area than that of the benign nodules(1.49±0.2 vs 1.15±0.06,P<0.05).When 1.24 was set as the cut-off point,the sensitivity and specificity of areas ratio in diagnosing thyroid cancer were 91.5%and 95.7%,respectively.Conclusions There are differences in the VTI between benign and malignant solid thyroid nodules.VTI has high applicative value in the differential diagnosis of thyroid solid nodules,due to its qualitative and quantitative evaluation of the hardness of the nodules.