声触诊组织成像和定量技术与螺旋CT对甲状腺结节良恶性应用比较

目的研究分析声触诊组织成像(VTI)和声触诊定量技术(VTQ)与螺旋CT对甲状腺结节良恶性应用比较。方法选取2017年1月至2019年3月于我院甲状腺外科经手术病理确诊的200例患者作为研究对象,所有入组患者入院后行常规甲状腺超声检查,分别测量VTQ模式下病灶内部横向剪切波速度(SWV)以及有效SWV测量区域,并在有效的测量区域中测量得到SWV最大值、SWV最小值、SWV中位数以及SWV平均值;以患者病理学诊断为依据对螺旋CT诊断甲状腺结节良恶性的准确度、特异度以及灵敏度进行计算;比较VTI和VTQ与螺旋CT对甲状腺结节良恶性诊断价值。结果TI-RADs2类阳性率为0%,TI-RADs3类阳性率为2.95%,TI-RADs4a类阳性率为2.95%,TI-RADs4b类阳性率20.59%,TI-RADs4c类阳性率58.82%,TI-RADs5类阳性率1.50%。螺旋CT扫描结果提示甲状腺良性结节114例,恶性结节86例;病理组织学提示甲状腺良性结节132例,恶性结节68例;特异度为86.8%,灵敏度为79.6%,准确度为34.0%。恶性结节SWV最大值、SWV最小值、SWV中位数以及SWV平均值明显高于良性结节,差异具有统计学意义(P<0.05)。甲状腺结节中SWV值最大值ROC曲线下面积为0.807、最小值ROC曲线下面积为0.815、中位数ROC曲线下面积为0.811以及平均值ROC曲线下面积为0.866,以及结节内SWV平均诊断效能为最佳,其敏感度为94.1%,特异度为85.7%,准确度为82.6%。结论VTI和VTQ与螺旋CT对甲状腺结节良恶性的鉴别诊断均具有良好的诊断价值,其SWV平均值对诊断甲状腺结节良恶性的鉴别诊断更具优势。

Comparison of Virtual Touch Tissue Imaging Quantification and Spiral CT in the Application of Benign and Malignant Thyroid Nodules

Objective To analyze the application of virtual touch tissue imaging(VTI)and virtual touch tissue quantification(VTQ)and spiral CT in the application of benign and malignant thyroid nodules.Methods From January 2017 to March 2019,200 patients confirmed by operation and pathology of our thyroid surgery department were enrolled as subjects.All patients underwent routine thyroid ultrasonogra phy after admission.The internal tra nsverse shear wave velocity(SWV)and the effective SWV measurement area of the lesion were measured under VTI mode,and the maximum SWV,minimum SWV,median SWV,and average SWV were obtained in the effective measurement area.Based on the pathological diagnosis of patients,the accuracy,specificity,and sensitivity of spiral CT in the diagnosis of benign and malignant thyroid nodules were calculated.The values of VTI,VTQ,and spiral CT in the diagnosis of benign and malignant thyroid nodules were compared.Results The positive rate of TI-RADs2 was 0%,the positive rate of TI-RADs3 was 2.95%,the positive rate of TI-RADs4 a was2.95%,the positive rate of TI-RADs4 b was 20.59%,and the positive rate of TI-RADs4 c was 58.82%,and the positive rate of TI-RADs5 was 1.50%.Spiral CT scan results showed 114 benign thyroid nodules,86 malignant nodules,pathological histology showed 132 benign thyroid nodules,68 malignant nodules;specificity 86.8%,sensitivity 79.6%,accuracy 34.0%.The maximum SWV,minimum SWV,median SWV,and average SWV of malignant nodules we re significantly higher than those of benign nodules(P<0.05).The maximum area under the ROC curve(AUC)was 0.807,minimum AUC 0.815,median AUC 0.811,and average AUC 0.866 for SWV value in the thyroid,and the average diagnostic power of SWV in the nodules was optimal,with a sensitivity of 94.1%,specificity 85.7%and the accuracy 82.6.Conlusion VTI and VTQ and spiral CT have a good diagnostic value for the differential diagnosis of benign and malignant thyroid nodules,in which the average value of SWV is better.