SWE联合SMI技术在鉴别甲状腺结节良恶性的诊断价值

Diagnostic Value of Shear Wave Elastography Combined with Superb Microvascular Imaging in the Differentiation of Benign and Malignant Thyroid Nodules

目的根据美国放射学会(ACR)TI-RADS分类标准,运用剪切波弹性成像(shear wave elastography,SWE)联合超微血管成像(superb microvascular imaging,SMI)技术对甲状腺结节良恶性诊断价值。方法选取105例甲状腺结节患者,共111个结节,所有患者均行常规超声检查、SWE、SMI技术检查,先行ACR TI-RADS分类,再以联合量化评分法重新调整TI-RADS分级,以病理结果为金标准,绘制受试者工作特征曲线(ROC),比较曲线下面积(AUC)及甲状腺良恶性结节的敏感度、特异性。结果111个甲状腺结节中良性结节48个,恶性结节63个,ACR TI-RADS分类诊断敏感度、特异性分别为79.4%、83.3%;联合后TI-RADS分类诊断诊断敏感度、特异性分别为98.4%、75%,联合前后的敏感度差异具有统计学意义(P<0.05),而两者特异性差异无统计学意义(P>0.05),ACR TI-ADS分级与联合模式诊断甲状腺结节良恶性得到的AUC分别为0.88、0.94,说明联合模式的诊断效能高于单一模式。结论SWE联合SMI技术优化TI-RADS分类可显著提高诊断甲状腺良恶性结节的诊断效能及敏感度。

Objective To evaluate the value of shear wave elastography(SWE)combined with superb microvascular imaging(SMI)in the diagnosis of benign and malignant thyroid nodules according to the TI-RADS classification criteria of American College of Radioloy(ACR).Methods 105 patients with 111 thyroid nodules were selected and treated with ultrasonography,SWE,and SMI.The ACR TI-RADS classification was performed first,and the TI-RADS classification was re-adjusted by the combined quantitative scoring method.The pathological results were used as the gold standard,and the receiver operating characteristic curve(ROC)was drawn to compare the area under the curve(AUC)and the sensitivity and specificity of the benign and malignant thyroid nodules.Results Of 111 thyroid nodules,48 were benign and 63 were malignant.The sensitivity and specificity of ACR TI-RADS classification diagnosis were 79.4%and 83.3%respectively.Those of the combined TI-RADS classification diagnosis were 98.4%and 75%respectively.The difference in sensitivity before and after the combination was statistically significant(P<0.05),but that in specificity was not statistically significant(P>0.05).The AUC for the diagnosis of benign and malignant thyroid nodules with ACR TI-ADS classification and combined model were 0.88 and 0.94 respectively,indicating that the combined model had higher diagnostic efficacy than the single model.Conclusion Combining SWE with SMI to optimize TI-RADS classification can significantly improve the efficacy and sensitivity in diagnosis of benign and malignant thyroid nodules.