剪切波弹性成像鉴别诊断甲状腺良恶性结节

目的:探讨实时剪切波弹性成像技术(shear wave elastography，SWE)在鉴别诊断甲状腺良恶性结节的应用价值。方法:对185例单发甲状腺肿物患者资料进行回顾性分析，评估SWE技术。结果:所有结节经病理证实，61个结节为良性，124个为恶性。恶性结节超声表现常呈低或极低回声，伴多发细点状微钙化，纵横比大于1，边界模糊，形态不规则。恶性结节的最大弹性模量值(Emax)为(58.5±26.5)kPa，平均杨氏模量为(41.8±32.6)kPa。良性结节的最大弹性模量值(Emax)为(38.5±15.7)kPa，平均杨氏模量为(29.5±17.7)kPa，两者之间的差异有统计学意义。最大弹性模量值(Emax)为55.4kPa、平均弹性模量值(Emean) 为45.6kPa、可疑结节与周围正常腺体弹性模量值之比(ER)为1.5，对良恶性结节的鉴别具有较高的灵敏性和特异性。结论:基于超声二维表现，综合SWE技术，对甲状腺结节良恶性进行鉴别诊断具有一定的价值。

Evaluation of shear wave elastography in differential diagnosis of thyroid nodules

Objective:To evaluate real -time shear wave elastography(SWE)for distinguishing malignant thyroid nodules.Methods:Analyzing retrospectively the 185 cases of solitary thyroid nodules to evaluate SWE technology.Re-sults:Compared with pathological results,61 nodules were benign,124 nodules malignant.Malignant nodules were of-ten hypoechogenicity,micro -calicification,taller than wide,ill -defined.Malignant nodules of the maximum elastic value(Emax )was (58.5 ±26.5)kPa,the mean elastic value was(41.8 ±32.6)kPa.Benign nodules of the maximum elastic value(Emax )was(38.5 ±15.7)kPa,the mean elastic value was(29.5 ±17.7)kPa,no difference between them.When the maximum elastic value(Emax )was 55.4kPa,the mean elastic value(Emean )was 45.6kPa,the elastic ratio value(ER)was 1.5,there was higher identification sensitivity and specificity between benign and malignant nodules.Conclusion:Based on the two -dimensional sonographic features,integrated SWE technique,there is certain valueable significant in diagnosising benign and malignant thyroid nodules.