甲状腺实性结节的超声弹性成像定量参数分析

目的 探讨实时超声弹性成像定量参数分析在诊断甲状腺实性结节性质中的价值.方法分析112例(157个病灶)甲状腺实性结节患者的超声弹性图像,计算病灶与周围组织的应变率比值及其平均值,并通过受试者操作特点(ROC)曲线分析取得最合适的诊断甲状腺良恶性病灶临界值.所有病例均经手术及病理证实.结果 157个病灶中良性结节79个,应变率比值平均值为1.93±1.29;恶性病灶78个,应变率比值平均值为5.07±4.21,两者间差异有统计学意义(t=6.319,P<0.01).根据良恶性结节的应变率比值绘制ROC曲线,曲线下面积为0.861±0.031.通过ROC 曲线分析得出良恶性结节的弹性应变率比值临界点为2.96,其敏感度、特异度和准确性分别为73.1%(57/78)、88.6%(70/79)和80.9%(127/157).结论 实时超声弹性成像定量参数分析为甲状腺实性结节的良恶性鉴别诊断提供了一种新方法.

Quantitative assessment of real-time ultrasound elastography in solid thyroid nodules

Objective To evaluate the value of quantitative analysis of real-time ultrasound elastography in the diagnosis of solid thyroid nodules. Methods The elastograms of 157 solid thyroid nodules in 112 patients were observed. The strain ratio of each lesion and the averages of those of benignancy and malignancy were calculated respectively. According to the ROC curve, the critical point of the strain ratio of different lesions was achieved. All the lesions were confirmed by surgery and pathologic examination. Results Of the 157 lesions, 79 were benign and 78 were malignant. The average of strain ratio of benign nodules was 1.93 ＋ 1.29 ,while that of malignancy was 5.07 ＋4.21. The strain ratio of benign and malignant lesions were of significant difference statistically （ t = 6. 319, P 〈 0.01 ）. According to the ROC curve, the critical point of strain ratio between benign and malignant lesions was 2.96, which displayed a sensitivity of 73.1% （57/78）, a specificity of 88.6% （70/79） and a accuracy of 80.9% （ 127/157 ）. Conclusion The quantitative analysis of real-time ultrasound elastography is a newly valuable technique of uhrasonography and helpful in the differential diagnosis of solid thyroid lesions.