弹性成像技术及硬环征对甲状腺良恶性结节诊断价值研究

Diagnostic value of elastography for benign and malignant thyroid nodules and hard ring sign

目的探究弹性成像技术及硬环征在甲状腺良恶性结节中的诊断价值。方法选择94例(121个结节)甲状腺结节患者为研究对象,分别对其实施弹性成像技术检查及剪切波弹性成像(SWE)分析,以病理检查结果为金标准(良性70个,恶性51个),分别计算SWE分析、弹性成像定量分析和联合检测对于甲状腺良恶性结节诊断的敏感性、特异度、准确性、阳性预测值以及阴性预测值,分别绘制SWE、弹性成像定量分析以及联合检测的受试者工作特征(ROC)曲线,并比较ROC曲线下面积。结果弹性定量分析检查显示良性结节69个,恶性52个,敏感性75.71%,特异度68.63%,阳性预测值76.81%,阴性预测值68.63%;SWE检查分析发现良性结节68个,恶性结节53个,敏感性80.00%,特异度76.47%,阴性预测值73.58%,阳性预测值82.35%;联合检测分析发现良性结节72个,恶性结节49个,敏感性95.71%,特异度90.20%,阴性预测值93.88%,阳性预测值94.37%;经对比,联合检测特异度、敏感性、阴性预测值和阳性预测值都比单独检测高(P<0.05);SWE、弹性成像定量分析与联合检测ROC曲线下面积分别是0.865、0.965、0.635,联合检测准确率比单一方法高(P<0.05)。结论弹性成像定量分析联合硬环征检测,可明显增强甲状腺结节良恶性病变诊断的特异性及敏感度,有较高的临床价值。

Objective To explore the diagnostic value of elastography and hard ring sign in benign and malignant thyroid nodules.Methods A total of 94 cases(121 nodules)with thyroid knots were selected.And the elastography technique and shear wave elastography(SWE)were performed respectively.The pathological examination results were gold standard(70 benign,51 malignant),and the quantitative analysis of elastography and SWE were respectively calculated.Sensitivity analysis and joint detection,sensitivity,specificity,accuracy,positive predictive value,negative predictive value for the diagnosis of benign and malignant thyroid nodules,respectively,plot the subjective work characteristics(ROC)of elastometric quantitative analysis,SWE,and combined detection.And the area under the ROC curve were compared.Results Elastic quantitative analysis diagnosed 69 benign nodules,52 malignant,sensitivity 75.71%,specificity 68.63%,negative predictive value 68.63%,positive predictive value 76.81%.SWE analyzed 68 benign nodules,53 malignant nodules,sensitivity 80.00%,specificity 76.47%,negative predictive value 73.58%,positive predictive value 82.35%.There were 72 benign nodules,49 malignant nodules,sensitivity 95.71%,specificity 90.20%,negative predictive value 93.88%,positive predictive value 94.37%.Comparison found sensitivity,specificity,positive predictive value,negative predictive value was higher than that of the single test(P<0.05).The area under SWE,the ROI curve of elastic imaging,and combined detection was 0.865,0.965,0.635,respectively.The combined detection accuracy was higher than the single method(P<0.05).Conclusion Elastic imaging quantitative analysis combined with hard ring sign detection can significantly improve the diagnostic sensitivity and specificity of benign and malignant thyroid nodules,and has a high clinical value.