剪切波弹性成像联合S-Detect智能辅助诊断技术在甲状腺微小乳头状癌淋巴结转移中的诊断价值

S-Detect combined with swe in the diagnosis of lymph node metastasis of papillary thyroid microcarcinoma

目的探究剪切波弹性成像(SWE)联合S-Detect智能辅助诊断技术在甲状腺微小乳头状癌淋巴结转移的诊断价值。方法选取2017年1月至2020年12月山西省中医院超声科诊断并进行治疗的120例甲状腺微小乳头状癌患者,男54例,女66例,年龄(46.87±2.90)岁,年龄范围为34~56岁。按照手术病理情况淋巴结是否转移分为转移组(n=44)与未转移组(n=76)。比较两组患者的一般资料、SWE诊断情况。采用Kappa检验对SWE诊断与病理结果的一致性进行分析、对S-Detect智能辅助诊断与病理结果的一致性进行分析、联合诊断效能分析、采用受试者工作特征曲线(ROC)对SWE诊断与S-Detect智能辅助诊断的曲线下面积进行比较。结果转移组患者的年龄、肿瘤形态不规则率、肿瘤边界不清晰率、存在钙化率、存在血流异常分布率显著高于未转移组,差异有统计学意义(P<0.05)。转移组患者的弹性模量值最大值[(66.10±11.77)kPa]、弹性模量值平均值[(46.76±11.17)kPa]、弹性模量值最小值[(14.55±5.77)kPa]均显著高于未转移组[(50.46±10.98)kPa、(32.98±11.01)kPa、(10.26±5.74)kPa],差异有统计学意义(P<0.05)。SWE诊断与病理结果的一致性较高,差异有统计学意义(Kappa=2.381,P=0.123)。S-Detect智能辅助诊断与病理结果的一致性较高,差异有统计学意义(Kappa=2.777,P=0.096)。联合诊断的准确率、特异度、阳性预测值均显著高于SWE诊断、S-Detect智能辅助诊断,差异有统计学意义(P<0.001)。联合诊断的ROC曲线下面积(0.892)高于SWE诊断(0.775)与S-Detect智能辅助诊断(0.603),差异有统计学意义(P<0.05)。结论SWE诊断联合S-Detect智能辅助诊断技术对于甲状腺微小乳头状癌淋巴结转移情况具有显著的鉴别意义,建议临床推广。

Objective To study the application of S-Detect combined with shear wave elastography(SWE)in the diagnosis of lymph node metastasis of thyroid papillary microcarcinoma.Methods A total of 120 cases of thyroid papillary microcarcinoma diagnosed and treated in department of ultrasound in Shanxi Hospital of traditional Chinese medicine from January 2017 to December 2020 were selected as the research objects,including 54 males and 66 females,aged(46.87±2.90)years old,ranging from 34 to 56 years old.According to whether the lymph node was transferred,they were divided into metastasis group(n=44)and non metastasis group(n=76).Comparing patients on general data and SWE diagnosis between the two groups.The general data and SWE diagnosis were compared between the two groups.The consistency between SWE diagnosis and pathological results was analyzed by Kappa test,the consistency between S-Detect intelligent diagnosis and pathological results was analyzed,the efficiency of combined diagnosis was analyzed,and the area under the curve between SWE diagnosis and S-Detect intelligent diagnosis was compared by receiver operating characteristic(ROC)curve.Results The age,irregular tumor shape rate,unclear tumor boundary rate,calcification rate and abnormal blood flow distribution rate of patients in metastasis group were significantly higher than those in non metastasis group(P<0.05).The maximum value of elastic modulus[(66.10±11.77)kPa],average value of elastic modulus[(46.76±11.17)kPa],minimum value of elastic modulus[(14.55±5.77)kPa]were significantly higher than those in non metastasis group[(50.465±10.98)kPa,(32.98±11.01)kPa,(10.26±5.74)kPa],the difference was statistically significant(P<0.05).There was a high consistency between SWE diagnosis and pathological results(Kappa=2.381,P=0.123).The consistency between S-Detect intelligent auxiliary diagnosis and pathological results was high,and the difference was statistically significant(Kappa=2.777,P=0.096).The accuracy,specificity and positive predictive value of combined diagnosis were significantly higher than those of SWE diagnosis and S-Detect intelligent diagnosis(P<0.001).The area of ROC curve of combined diagnosis(0.892)was significantly higher than that of SWE diagnosis(0.775)and S-Detect intelligent auxiliary diagnosis,the difference was statistically significant(P<0.05).Conclusion S-Detect intelligent auxiliary diagnostic technology combined with SWE has significant differential significance for lymph node metastasis of thyroid micro papillary carcinoma,and it is recommended to be popularized in clinic.