超声剪切波弹性成像在甲状腺良恶性肿瘤中的鉴别价值及超声征象特征研究

Study on the Differential Value of Ultrasonic Shear Wave Elastography in Thyroid Benign and Malignant Tumors and the Characteristics of Ultrasonic Signs

目的:探讨超声剪切波弹性成像在甲状腺良恶性肿瘤中的鉴别价值及超声征象特征。方法:选择2020年1月~2022年6月甲状腺结节患者85例为对象,均常规行超声剪切波弹性成像检查,以病理检查结果为“金标准”,绘制ROC曲线,分析超声剪切波弹性成像在甲状腺结节良恶性中的鉴别效能;比较甲状腺良恶性肿瘤患者甲状腺结节与周围组织的杨氏模量值(E)及超声征象特征。结果:85例患者经病理确诊恶性31例,良性54例。超声剪切波弹性成像检查恶性28例,良性57例。超声剪切波弹性成像在甲状腺良恶性肿瘤中鉴别灵敏度为83.87%(26/31)、特异度为96.30%(52/54);甲状腺恶性肿瘤患者E_(max)、E_(min)、E_(mean)水平高于甲状腺良性肿瘤患者(P<0.05);甲状腺恶性肿瘤患者数目(多发)、肿块形态(不规则)、呈蟹足样浸润(是)、血流信号(丰富)检出率高于甲状腺良性肿瘤患者(P<0.05)。结论:超声剪切波弹性成像能提高甲状腺良恶性肿瘤的鉴别灵敏度和特异度,且恶性肿瘤具有更高的E值,具有典型的超声征象,能为临床诊疗提供超声依据。

Objective:To explore the differential value of ultrasonic shear wave elastography in thyroid benign and malignant tumors and the characteristics of ultrasonic signs.Methods:85 patients with thyroid nodules from January 2020 to June 2022 were selected as the subjects.All of them were routinely examined by ultrasonic shear wave elastography.Taking the pathological examination results as the“gold standard”,the ROC curve was drawn,and the discrimination efficiency of ultrasonic shear wave elastography in benign and malignant thyroid nodules was analyzed;To compare the Young’s modulus(E)and ultrasound features of thyroid nodules and surrounding tissues in patients with benign and malignant thyroid tumors.Results:85 patients,31 were malignant and 54 were benign.Ultrasound shear wave elastography showed that 28 cases were malignant and 57 cases were benign.The sensitivity and specificity of ultrasonic shear wave elastography in differentiating benign and malignant thyroid tumors were 83.87%(26/31)and 96.30%(52/54)respectively;The levels of E_(max),E_(min) and E_(mean) in patients with thyroid malignant tumors were higher than those in patients with thyroid benign tumors(P<0.05);The number of patients with thyroid malignant tumor(multiple),tumor shape(irregular),crab foot infiltration(yes),and blood flow signal(rich)detection rate were higher than those with thyroid benign tumor(P<0.05).Conclusion:Ultrasonic shear wave elastography can improve the sensitivity and specificity of differential diagnosis of thyroid benign and malignant tumors,and malignant tumors have higher E value and typical ultrasonic signs,which can provide ultrasonic basis for clinical diagnosis and treatment.