超声实时组织弹性成像技术与磁共振表观弥散系数诊断良恶性甲状腺结节的对比研究

Comparative study of ultrasound RTE and MR ADC in diagnosing benign and malignant thyroid nodule

目的:比较研究超声实时组织弹性成像(RTE)技术与磁共振弥散加权成像(MRDWI)表观弥散系数(ADC)值对良恶性甲状腺结节的诊断价值。方法:选取医院就诊的67例(95个结节)甲状腺结节患者临床及影像学资料,所有患者术前均进行RTE技术及MRDWI检查,以术后病理结果为“金标准”,对比分析两种检查方法对良恶性甲状腺结节诊断的准确率、灵敏度和特异度。结果:在95个甲状腺结节中,术后病理诊断良性甲状腺结节61个(占64.21%),其中结节性甲状腺肿47个(占77.05%);恶性甲状腺结节34个(占35.79%),其中乳头状癌最多(占88.24%)。RTE技术的诊断准确率为91.57%(87/95),与MRDWI的ADC值定量检查的90.53%(86/95)比较,差异无统计学意义(x^(2)=0.065,P>0.05);RTE技术的诊断灵敏度为96.61%,与MRDWI的ADC值定量检查的93.44%比较,差异无统计学意义(x^(2)=0.634,P>0.05);RTE技术的诊断特异度为83.33%,与MRDWI的ADC值定量检查的85.29%比较,差异无统计学意义(x^(2)=0.051,P>0.05)。结论:RTE技术与MR DWI的ADC值定量检查对良恶性甲状腺结节的诊断准确率较高,均具有良好的鉴别诊断价值,可在临床上推广应用。

Objective: To compare the diagnostic value of real-time tissue elastography(RTE) technique of ultrasound and apparent diffusion coefficient(ADC) values of magnetic resonance(MR) diffusion-weighted imaging(DWI) on benign and malignant thyroid nodules. Methods: The clinical and imaging data of 67 patients with 95 thyroid nodules who admitted to hospital were selected. All patients underwent RTE ultrasound and MR DWI examination. The pathological results after surgery were used as “gold standard”. And the accuracy, sensitivity and specificity of the two examinations were compared and analyzed in diagnosing benign and malignant thyroid nodules. Results: In 95 thyroid nodules, 61 nodules(64.21%) were confirmed as benign nodules by pathological results after surgery, and 47 nodules(77.05%) of them were nodular goiter, and 34 nodules of them were malignant thyroid nodules(35.79%), of which papillary carcinoma was the most(88.24%). The diagnostic accuracy of RTE technique was 91.57%(87/95), which was not statistically significant with 90.53%(86/95) of ADC quantitative examination of MR DWI(χ^(2)=0.065, P>0.05). The diagnostic sensitivity of RTE technique was 96.61%, which was not statistically significant with 93.44% of ADC value of MR DWI(χ^(2)=0.634, P>0.05). In addition, the diagnostic specificity of RTE technique was 83.33%, which was not statistically significant with 85.29% of ADC value of MR DWI(χ^(2)=0.051, P>0.05). Conclusion: Both RTE technique and the quantitative examination of ADC value of MR DWI have higher diagnostic accuracy for benign and malignant thyroid nodules. They all have better differential diagnostic value and can be applied in clinical diagnosis.