VTIQ测量剪切波速度对甲状腺微小结节的诊断价值

目的探讨声触诊组织成像与定量（VTIQ）技术测量剪切波速度（SWV）对甲状腺影像报告和数据系统（TI-RADS）4级微小结节的诊断价值。方法选择150例甲状腺TI-RADS 4级微小结节病人为研究对象，在超声学检查中采用VTIQ技术对结节组织的SWV参数（SWVmean、SWVstd、SWVmax、SWVmin、SWVratio）进行测量，以病理诊断结果作为金标准，绘制ROC分析VTIQ技术测量SWV对于甲状腺TI-RADS 4级微小结节的诊断效能。结果150例病人共发现168个微小结节，其中恶性病人65例（70个微小结节），良性病人85例（98个微小结节）。恶性微小结节的SWVmean、WVstd、SWVmax、SWVmin和SWVratio均明显大于良性微小结节（P < 0.01）。SWVmean、SWVstd、SWVmax、SWVmin和SWVratio对微小结节的良恶性均具有较高的诊断价值（P < 0.01），SWVmean的诊断效能最高[AUC（95%CI）=0.830（0.712~0.920），P < 0.01]，截断值=2.755时，灵敏度、特异度、阳性预测值、阴性预测值分别为75.48%、93.04%、86.85%、83.79%。结论VTIQ技术测量SWV能够明显辨别甲状腺TI-RADS 4级微小结节良恶性的差异性，具有较好的诊断价值；当SWVmean>2.755 m/s时提示可能为恶性微小结节。

Diagnostic value of VTIQ measuring shear wave velocity in thyroid micronodule

ObjectiveTo explore the diagnostic value of virtual touch tissue imaging quantification(VTIQ)measuring shear wave velocity(SWV)in thyroid imaging report and data system(TI-RADS)grade 4 micronodules.MethodsOne hundred and fifty thyroid micronodule patients with TI-RADS grade 4 were investigated, and the SWV parameters(SWVmean, SWVstd, SWVmax, SWVmin and SWVratio)of nodular tissue in all cases were measured using VTIQ in ultrasonography.The pathological diagnosis was taken as gold standard, the receiver operating characteristic(ROC) curve was drawn to analyze the diagnostic efficacy of VTIQ measuring SWV on thyroid micronodules with TI-RADS grade 4.ResultsAmong 150 patients, 168 micronodules were found, which included 65 malignant patients(70 micronodules)and 85 benign patients(98 micronodules).The SWVmean, SWVstd, SWVmax, SWVmin and SWVratio in malignant micronodules were significantly greater than those in benign micronodules(P < 0.01).The SWVmean, SWVstd, SWVmax, SWVmin and SWVratio had significant diagnostic value on the benign and malignant micronodules(P < 0.01), and the diagnostic efficacy of SWVmean was the highest(P < 0.01).When the cut-off value was set as 2.755, the sensitivity, specificity, positive predictive value and negative predictive value of SWVmean were 75.48%, 93.04%, 86.85% and 83.79%, respectively.ConclusionsThe VTIQ measuring SWV can significantly distinguish the differences of benign and malignant thyroid micronodules with TI-RADS grade 4, which has a good diagnostic value.When SWVmean is more than 2.755m/s, it suggests the possibility of malignant micronodules.