超声E成像在甲状腺实性结节中的临床应用价值

Clinical Application Value of Ultrasound E-imaging in Thyroid Solid Nodules

目的:分析甲状腺实性结节诊断中应用超声实时剪切波弹性成像(shear wave elasography, SWE)杨氏模量最大值(Emax)的效果。方法:选取2017年1月-2019年12月于我院就诊的甲状腺结节患者作为研究对象,所有纳入的125例(134个结节)患者均行超声甲状腺结节诊断和病理学诊断。选择最佳观察切面,启用SWE模式,记录杨氏模量横断面和纵断面的最大值(Emax)和平均值(Emean),然后对比良性结节和恶性结节间Emax和Emean差异,绘制ROC曲线,计算临界值。结果:经病理检查125例患者(134个结节)有48个恶性结节,86个良性结节,经统计学分析,恶性结节组患者的纵断面和横断面SWE最大值和平均值均明显高于良性结节组,差异具有统计学意义(P<0.05)。ROC曲线结果显示134个结节,E-成像弹性模量截断值,最大值为43.28kpa,平均值为24.32kpa,曲线下面积分别为0.807和0.746,诊断良恶性甲状腺结节的敏感性分别为82.98%和76.54%,特异度分别为76.28%和74.39%。结论:SWE是一种定量测量方法,在甲状腺恶性结节诊断中具有十分重要意义。

Objective:To observe the clinical application value of ultrasound real-time shear wave elasticity(SWE) Young’s modulus maximum(Emax) in the diagnosis of thyroid solid nodules.Methods:125 patients(134 nodules) who underwent ultrasound thyroid nodule diagnosis and treatment in our hospital from January 2017 to December 2019 were selected as the research object. All patients underwent thyroid fine needle aspiration biopsy or surgery and were confirmed pathologically. Ultrasonic examination was used to select the best observation section, SWE mode was enabled, and the maximum(Emax) and average(Emean) values of Young’s modulus cross-section and longitudinal section were recorded. Then the differences between Emax and Emean between benign nodules and malignant nodules were compared, ROC curves were drawn, and critical values were calculated.Results:48 malignant nodules and 86 benign nodules in 125 patients were pathologically detected. through statistical analysis, the maximum and average values of SWE in longitudinal and transverse sections of malignant nodules were significantly higher than those in benign nodule group, with statistically significant difference(p<0.05). ROC curve showed 134 nodules. The cutoff value of E-imaging elastic modulus was 43.28 kpa at the maximum and 24.32 kpa at the average. The area under the curve was 0.807 and 0.746 respectively. The sensitivity, specificity and specificity for diagnosis of benign and malignant thyroid nodules were 82.98% and 76.54% and 76.28% and 74.39% respectively.Conclusion:SWE is a quantitative measurement method and is of great significance in the diagnosis of thyroid malignant nodules.