声脉冲辐射力弹性成像技术在鉴别诊断甲状腺良、恶性结节中的作用

Role of acoustic radiation force impulse imaging in differential diagnosis of benign and malignant thyroid nodules

目的探究声脉冲辐射力弹性成像技术(ARFI)在鉴别诊断甲状腺良、恶性结节中的作用。方法选择2018年1月至2020年9月我院经穿刺活检或手术病理证实的甲状腺结节患者67例(82个甲状腺结节),给予常规彩色多普勒超声检查与ARFI技术中的声触诊组织成像技术(VTI)和声触诊组织定量技术(VTQ)检查。比较VTI面积与二维(2D)超声图像结节面积比值(AR)、VTQ剪切波速度(SWV)及结节与周围正常甲状腺组织剪切波速度比值(R-SWV)3种方式鉴别甲状腺良、恶性结节结果的差异。结果甲状腺恶性结节VTI显示图像较甲状腺良性结节更黑。甲状腺恶性结节的AR、SWV及R-SWV平均值较甲状腺良性结节明显增高(P<0.001);AR、SWV、R-SWV诊断甲状腺恶性结节的Cut off值分别为1.47、2.12 m/s、1.30。结论应用AFRI技术中的VTI、VTQ技术能定量、定性反映甲状腺结节的弹性成像特征,对甲状腺良、恶性结节具有一定的辅助诊断价值。

Objective To explore the role of acoustic radiation force impulse imaging(ARFI)in differential diagnosis of benign and malignant thyroid nodules.Methods A total of 67 patients(82 thyroid nodules)confirmed by puncture biopsy or surgical pathology in our hospital from January 2018 to September 2020 were selected and examined by conventional color Doppler ultrasound,virtual touch imaging(VTI)and virtual touch quantification(VTQ)in ARFI.The differences of results between benign and malignant thyroid nodules were identified by three methods of comparing ratio of VTI area to two-dimensional(2D)ultrasound image nodule area(AR),VTQ shear wave velocity(SWV)and shear wave velocity ratio(R-SWV)between nodule and surrounding normal thyroid tissue.Results The VTI image of malignant thyroid nodule was darker than that of benign thyroid nodule.The average values of AR,SWV and R-SWV in malignant thyroid nodule were significantly higher than those in benign thyroid nodule(P<0.001).The Cut off values of AR,SWV and R-SWV in the diagnosis of malignant thyroid nodule were 1.47,2.12 m/s and 1.30 respectively.Conclusion The application of VTI and VTQ in AFRI can quantitatively and qualitatively reflect the elastic imaging characteristics of thyroid nodule,and has certain auxiliary diagnostic value for the benign and malignant thyroid nodules.