常规超声联合实时剪切波弹性成像定量参数对大网膜结核的诊断价值

目的探讨常规超声与剪切波弹性成像(SWE)定量参数单独及联合应用时对大网膜结核的诊断价值。方法选取于我院在网膜穿刺活检前均行常规超声及SWE检查的80例患者,根据病理结果将其分为结核组(30例)和非结核组(50例),分析常规超声对网膜结核诊断的灵敏度、特异度及准确度;对结核组与非结核组SWE定量参数(Emean、Emin、Emax、SD)进行统计分析并建立ROC曲线评价其诊断效能;分析常规超声联合SWE后对网膜结核的诊断效能。结果常规超声检查诊断网膜结核的灵敏度、特异度及准确度分别为86.67%、82.00%、83.75%;结核组与非结核组杨氏模量值Emean、Emin、Emax、SD差异均有统计学意义(P<0.001),其中Emean诊断效能最大,以29.7kPa为诊断网膜结核的界值时,其灵敏度、特异度及准确度分别为100%、63.83%、82.50%;常规超声联合SWE诊断网膜结核的灵敏度、特异度、准确度分别为96.67%、94.00%、95.00%。结论实时剪切波弹性成像可作为网膜结核穿刺前有效、无创的辅助检查方法,联合常规超声检查后对网膜结核的诊断效能优于两者的独立应用。

Diagnostic Value of Conventional Ultrasound Combined with Shear Wave Elastography Quantitative Parameters in the Greater Omental Tuberculosis

Objective To evaluate the diagnostic value of routine ultrasonography and shear wave elastography(SWE) quantitative parameters in the diagnosis of greater omental tuberculosis. Methods Eighty patients who underwent routine ultrasonography and SWE examination of thickened omentum before omentum biopsy in our hospital from, which were divided into tuberculosis group(30 cases) and non-tuberculosis group(50 cases) according to the pathological results.The sensitivity,specificity and accuracy of routine ultrasonography for omental tuberculosis were analyzed.The quantitative parameters of SWE(Emean,Emin,Emax,SD) in tuberculosis group and non-tuberculosis group were analyzed,and ROC curve was established to evaluate the diagnostic efficacy.The diagnostic efficacy of routine ultrasonography combined with SWE for omental tuberculosis was analyzed. Results In this study,the sensitivity,specificity and accuracy of routine ultrasonography in the diagnosis of omental tuberculosis were 86.67%,82.00% and 83.75% respectively.And there were significant differences in Young′s modulus(Emean,Emin,Emax,SD) between tuberculosis group and non-tuberculosis group(P<0.001),among which Emean was the most effective one and taking 29.7 kPa as the diagnostic threshold,the sensitivity,specificity and accuracy were 100%,63.83% and 82.50% respectively.And 96.67%, 94.00% and 95.00% for the diagnosis of omental tuberculosis after routine ultrasonography combined with SWE. Conclusions Shear wave elastography can be used as an effective and non-invasive auxiliary examination before puncture of omental tuberculosis,the diagnostic efficiency of combined routine ultrasonography for omental tuberculosis is superior to the independent application of two methods.