声触诊组织量化成像技术对局灶型亚急性甲状腺炎与甲状腺乳头状癌的鉴别诊断价值

目的:探讨常规超声及声触诊组织量化成像技术(virtual touch tissue imaging quantification,VTIQ)对局灶型亚急性甲状腺炎(subacutethyroiditis,SAT)和甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的鉴别诊断价值。方法:选取经细针穿刺或手术病理证实的27例局灶型SAT和30例PTC病例资料,分析2组病变常规超声和VTIQ的图像特征。结果:局灶型SAT组出现边界模糊的比例高于PTC,差异有统计学意义(P<0.05)。局灶型SAT组有9例出现回声向心性减低,7例内部呈低回声夹杂斑片状高回声,而PTC组均无此超声特点。局灶型SAT组病变内剪切波速度(shear wave velocity,SWV)的平均值为(4.23±0.89)m/s,PTC组SWV的平均值为(3.12±0.26)m/s。2组SWV的平均值间差异有统计学意义(P<0.05)。VTIQ能够实时定量测量甲状腺结节的硬度,对于SWV超过3.58 m/s的甲状腺结节,做TI-RARD降级处理后发现,诊断效能明显上升。结论:局灶型SAT与PTC二维超声图像特征存在交叉重叠现象,易将局灶型SAT误诊为甲状腺恶性肿瘤。VTIQ对局灶型SAT与PTC的鉴别诊断有一定的辅助诊断价值。

Value of virtual touch tissue imaging quantification in differential diagnosis of subacute thyroiditis and papillary thyroid carcinomas

Objective: To investigate the value of virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of subacute thyroiditis (SAT) and thyroid papillary carcinoma (PTC). Methods: 27 patients with SAT and 30 patients with PTC confirmed by fine needle puncture or pathology were selected. The conventional ultrasound and VTIQ features were analyzed and compared with the final pathological results. Results: Poorly defined margin and calcification were significant different between SAT and PTC groups (P<0.05); centripetal reduction echogenicity was observed more frequently between two groups. There were 9 cases with centripetal hypoechoic in SAT group, 7 cases with hypoechoic and patchy hyperechoic in the interior, but none in PTC group (P<0.05). The average shear wave velocity (SWV) value of PTC group was (3.12±0.26) m/s and the average SWV value of SAT group was (4.23±0.89) m/s (P<0.05). Conclusions: Overlap of conventional US features exists between the SAT and PTC groups, which is easily misdiagnose focal SAT as thyroid malignat tumor. However, the poorly defined margin and centripetal reduction echogenicity are useful indicators for differential diagnosis. With the help of VTIQ, the diagnostic accuracy might be improved.