超声实时组织弹性成像技术定量评价甲状腺肿块的应用价值

目的 探讨超声实时组织弹性成像技术定量评价甲状腺良恶性肿块的应用价值.方法 对73例甲状腺肿块患者共95个病灶,应用实时组织弹性成像技术获得肿块应变率与胸锁乳突肌弹性应变率比值,判断病灶的良恶性,并与术后病理结果进行对照,绘制ROC曲线图,获得区分甲状腺肿块良恶性应变率比值的临界值.结果 ①甲状腺肿块良性组弹性应变率比值为2.06 ±1.01,恶性组弹性应变率比值为5.05 ±2.23,两组间差异有统计学意义(P＜0.05).②甲状腺良恶性肿块弹性应变率比值的ROC曲线下面积为0.929,差异有统计学意义(P＜0.05).③通过ROC曲线确定良、恶性肿块弹性应率比值的临界点为3.17,其灵敏度、特异度、阳性预测值、阴性预测值分别为96.7%、90.8%、93.3%和96.9%.结论 超声实时组织弹性成像技术可以简便、无刨、定量地对甲状腺良、恶性肿块进行鉴别诊断.

The value of quantitative analysis in thyroid nodules by real-time tissue elasticity imaging

Objective To evaluate the value of the real-time tissue elasticity imaging quantitative method in differential diagnosis of thyroid nodules.Methods Seventy-three patients with thyroid nodules，including 95 lesions,were included in the study.A total of thyroid nodules were examined with traditional ultrasonography and elastosonography from which the strain ratios(SR)were derived，with pathologic results as the reference standard.And a receiver-operating charaeterisitc(ROC)curve was used to identify the value of optimal operating point for differential diagnosis of thyroid nodules.Results ①The strain ratio of the benign lesions was 2.06 ±1.01，which was significantly different from the value of malignant lesions 5.05±2.23(P＜0.05).②The area under the curve was 0.929，which showed a high statistical significance.③It showed that the optimal operating point of ROC curve was 3.17，with high sensitivity(96.7%)，specificity(90.8%)，postive predictive value (93.3%)and negative predictive value(96.9%).Conclusions The real-time tissue elasticity imaging can provide a quantitative,noninvasive and convenient tool for evaluating the thyroid nodules.