超声弹性成像SR值鉴别甲状腺良恶性结节的价值及病理类型、结节最大径及钙化对SR值的影响

目的：分析超声弹性成像应变率比值(SR)鉴别甲状腺良恶性结节的价值及结节类型、结节最大径及钙化对SR值的影响。方法：采用回顾性研究,收集本院86例(93枚)甲状腺结节患者的临床资料,记录患者常规超声影像学特征和纵切面上的SR值。通过绘制受试者工作特征(ROC)曲线以分析SR值对鉴别甲状腺良恶性结节的诊断效能,采用相关性分析恶性结节超声影像学特征与SR值的关系,并采用多元线性回归分析超声影像学特征对SR值的影响。结果：SR值鉴别甲状腺良恶性结节的最佳诊断阈值为3.65,此时对应的敏感度为86.44%,特异度为82.76%,ROC曲线下面积为0.88。相关性分析发现,结节最大径、钙化与恶性结节SR值均具有一定正相关关系(P<0.05),而其它特征与SR值并无密切关系(P>0.05)。进一步行多元线性回归分析发现,结节类型、最大径和钙化进入回归方程,其中结节类型对SR值影响最大(P<0.05)。结论：超声弹性成像SR值具有良好的诊断价值,可作为临床鉴别甲状腺结节良恶性的重要参数,SR值与结节类型、结节最大径、钙化密切相关,其中结节类型是SR值最显著的影响因素,而结节形态、内部成分、所处深度、边界、内部血流对SR值影响不大。

Value of SR Value of Ultrasound Elastography in Differentiating Benign and Malignant Thyroid Nodules and the Effect of Pathological Type, Maximum Diameter of Nodules and Calcification on SR Value

Objective: To analyze the value of strain ratio (SR) value of ultrasound elastography in differentiating benign and malignant thyroid nodules and the influence of nodule type, nodule maximum diameter and calcification on SR value. Methods: A retrospective study was conducted to collect the clinical data of 86 patients with thyroid nodules (93 pieces) in our hospital, and to record the routine ultrasonographic features and SR values on the longitudinal section of the patients. The diagnostic efficacy of SR value in differentiating benign and malignant thyroid nodules was analyzed by drawing receiver operating characteristic (ROC) curve. The relationship between SR value and ultrasound imaging characteristics of malignant thyroid nodules was analyzed by correlation analysis, and the influence of ultrasound imaging characteristics on SR value was analyzed by multiple linear regression analysis. Results: The best diagnostic threshold of SR value for differentiating benign and malignant thyroid nodules was 3.65. The corresponding sensitivity was 86.44%, specificity was 82.76% and the area under ROC curve was 0.88. The correlation analysis showed that the maximum diameter and calcification of nodules were positively correlated with SR value of malignant nodules (P < 0.05), while other characteristics were not closely correlated with SR value (P > 0.05). Further multiple linear regression analysis showed that nodule type, maximum diameter and calcification entered the regression equation, and nodule type had the greatest influence on SR value (P < 0.05). Conclusion: The SR value of ultrasound elastography has good diagnostic value and can be used as an important parameter to differentiate benign and malignant thyroid nodules. SR value is closely related to the type of nodules, the largest diameter of nodules and calcification. The type of nodules is the most significant factor affecting SR value, while the shape, internal composition, depth, boundary and internal blood flow of nodules have little effect on SR value.