声辐射力脉冲成像技术对甲状腺的应用研究

目的以甲状腺为高频超声脉冲声辐射成像(acoustic radiation force impulse,ARFI)技术的应用对象,探讨ARFI技术的可重复性及不同操作者之间的一致性。研究被测者呼吸、取样框靠近颈动脉处、探头加压、探头倾斜、横切、取样框的深度等因素对ARFI值的影响,并研究不同测量次数ARFI值均值间的差异,探求最佳的重复测量次数。方法 2名资历相同的超声医生对随机抽取的30名正常甲状腺受试者进行重复测值,行一致性检验;对2名受试者的左侧甲状腺进行一系列分组设计的测量,评价各个因素对ARFI值的影响;对40例甲状腺结节患者术前行结节及非结节部位的ARFI测值,重复测量5次以上,分为3组:前3次测量数值的均数、前5次测量的均数及所有测量次数的均数,结合术后病理分型进行分析。结果高频探头ARFI技术的重复性、一致性较好;探头加压、横切、倾斜、取样框靠近颈动脉搏动处及深度对ARFI值差异有显著性,是否屏气对ARFI值差异无显著性;对甲状腺非结节部位的测量只需3次,对可疑恶性结节需重复测量5次及以上。结论只有规范、合理地应用ARFI技术才能正确地反映甲状腺及甲状腺结节的软硬程度。

Acoustic Radiation Force Impulse Technology:the Application Study of Thyroid

Objective To evaluate acoustic radiation force impulse(ARFI) technology′s repeatability and consistency in the application of thyroid.To find out which are the influence factors among breath,sampling frame location(near the carotid artery area and different depth),probe compression,probe tilt and crosscut.The best measurement times are also assessed.Methods ARFI technology was applicated in 30 normal subjects to do the consistency check by two sonographers of the same qualifications.A series of designed measurements on the left thyroid of two normal volunteers were obtained and analysed.Totally 40 patients with thyroid nodules were underwent ARFI measurement above 5 times before operation.Gained values were divided into three groups: mean value of ahead three times measurements,mean value of ahead five times measurements and mean value of all measurements.Combined with pathological classification,the three groups of data were analysed.Results ARFI technology had good repeatability and consistency.Probe compression,probe lean,crosscut and sampling frame location had statistical significance,except breath.For suspiciously malignant nodules,measurement should be repeated more than 5 times,and other nodules can measured only three times.Conclusion Only standard and reasonable application of ARFI technology could it reflect thyroid elasticity effectively and reliably.