上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

声触诊组织成像在甲状腺实性结节鉴别诊断中的应用价值

韩蕊君，李凤华，王燕，李红丽，王筱玲   

  1. 上海交通大学 医学院附属仁济医院超声医学科， 上海 200127
  • 出版日期:2015-06-28 发布日期:2015-07-30
  • 通讯作者: 李凤华, 电子信箱: prfenghuali@126.com。
  • 作者简介:韩蕊君（1982—）， 女， 住院医师， 硕士; 电子信箱: jine_nina@hotmail.com。

Application value of virtual touch tissue imaging for differential diagnosis of thyroid solid nodules

HAN Rui-jun, LI Feng-hua, WANG Yan, LI Hong-li, WANG Xiao-ling   

  1. Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2015-06-28 Published:2015-07-30

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摘要：

目的 探讨声辐射力脉冲成像中声触诊组织成像（VTI）技术的弹性图分级法和面积比在甲状腺实性结节良恶性诊断中的价值。方法 对152例甲状腺结节患者的194个实性结节行常规超声、超声弹性成像（EI）和VTI检查。绘制受试者工作特征曲线（ROC曲线），研究VTI弹性图分级、面积比和超声EI弹性图评分在鉴别诊断甲状腺良恶性结节中的价值及诊断表现。结果 甲状腺恶性结节（甲状腺癌）的VTI弹性图分级显著高于良性结节(P<0.001)；且恶性结节的VTI面积比显著大于良性结节(P<0.001)。ROC曲线分析结果显示：VTI弹性图分级法的最佳阈值为Ⅳ级；面积比的最佳阈值为1.05；VTI弹性图分级的ROC曲线下面积显著大于超声EI弹性图评分法和VTI面积比（P<0.05）。结论 VTI弹性图分级法和面积比可为甲状腺实性结节良恶性鉴别诊断提供有用信息，且VTI弹性图分级法的诊断价值高于超声EI弹性图评分法和VTI面积比。

关键词: 声触诊组织成像, 声辐射力脉冲成像, 甲状腺癌, 甲状腺结节, 超声弹性成像

Abstract:

Objective To explore the value of elastogram grading and area ratio of virtual touch tissue imaging (VTI) of acoustic radiation force impulse imaging for the differential diagnose of benign and malignant thyroid solid nodules. Methods A total of 194 thyroid solid nodules of 152 patients were underwent conventional ultrasound, ultrasound elasticity imaging (EI), and VTI examinations. Receiver-operating characteristic (ROC) curves were plotted. The value and diagnostic performance of VTI elastogram grading, area ratio, and ultrasound EI elastogram scoring for the differential diagnosis of benign and malignant nodules were studied. Results The VTI elastogram grades of malignant thyroid nodules (thyroid carcinoma) were significantly higher than those of benign nodules (P<0.001) and VTI area ratios of malignant nodules were significantly bigger than those of benign nodules (P<0.001). Results of ROC curve analysis showed that the optimal threshold value of VTI elastogram grading was grade IV and the optimal threshold value of area ratio was 1.05. The area under ROC curve of VTI elastogram grading was significantly larger than those of EI elastogram scoring and VTI area ratio (P<0.05). Conclusion VTI elastogram grading and area ratio can provide useful information for the differential diagnosis of malignant and benign thyroid solid nodules. The diagnostic performance of VTI elastogram grading is better than that of EI elastogram scoring and VTI area ratio.

Key words: virtual touch tissue imaging, acoustic radiation force impulse, thyroid nodule, thyroid carcinoma, ultrasound elasticity imaging