摘要
目的分析声脉冲辐射力成像模块中的虚拟声触诊组织定量-剪切波速度(virtual Touch tissue quantification-shear wave velocity,VTQ-SWV)技术诊断甲状腺不同直径范围结节的符合率,比较甲状腺不同直径范围结节对ARFI模块中VTQ-SWV技术测值准确性的影响,以提高VTQ-SWV技术在甲状腺不同直径范围结节中良、恶性的鉴别诊断价值。方法选取2017年1月至2021年6月在陕西省宝鸡市人民医院就诊的门诊及住院行甲状腺病灶细针穿刺细胞学检查(fine needle aspiration cytology,FNAC)、粗针穿刺活检或手术的346例患者,应用常规超声及ARFI检查并经病理学证实共有369个结节(结节直径范围3.0~45.0 mm),以病理结果为"金标准",按结节直径大小范围分为3.0~10.0 mm、11.0~20.0 mm、21.0~30.0 mm及31.0~45.0 mm共4组,依据VTQ-SWV诊断甲状腺结节的Cut off值,分别对4组不同直径范围结节进行ROC曲线分析。结果VTQ-SWV在直径11.0~20.0 mm范围组结节中的诊断总符合率最高(72.14%),在直径3.0~10.0 mm范围组结节中的诊断总符合率最低(13.56%)。对4组不同直径范围甲状腺结节的VTQ-SWV测值行ROC曲线分析,结果显示,结节直径为3.0~10.0 mm组中,曲线下面积AUC=0.651,鉴别良恶性VTQ-SWV的Cut off值为2.29 m/s时灵敏度为59.1%,特异度为67.6%;结节直径为11.0~20.0 mm组中曲线下面积AUC=0.883,鉴别良恶性VTQ-SWV的Cut off值为3.23 m/s时灵敏度为83.0%,特异度为89.7%;结节直径为21.0~30.0 mm组中曲线下面积AUC=0.777,鉴别良恶性VTQ-SWV的Cut off值为2.76 m/s时灵敏度为80.4%,特异度为74.4%;结节直径为31.0~45.0 mm组中曲线下面积AUC=0.720,鉴别良恶性VTQ-SWV的Cut off值为3.35 m/s时灵敏度为68.7%,特异度为77.6%。结论应用VTQ-SWV技术检查直径范围在10.0~30.0 mm甲状腺结节的良、恶性鉴别诊断最有价值;VTQ-SWV对直径为31.0~45.0 mm甲状腺结节进行检查对穿刺活检有一定指导意义。
Objective To analyze the coincidence rate of virtual touch tissue quantification-shear wave velocity(VTQ-SWV) in the acoustic radiation force impulse(ARFI) module in the diagnosis of thyroid nodules with different diameters, and to compare the influence of thyroid nodules with different diameters on the accuracy of VTQ-SWV in ARFI module, so as to improve the value of VTQ-SWV in the differential diagnosis of benign and malignant thyroid nodules with different diameters. Method A total of 346 patients with thyroid lesions who underwent fine-needle biopsy, coarse-needle biopsy or surgery in Baoji People’s Hospital were selected from January 2017 to June 2021. A total of369 nodules(the diameter of nodules ranged from 3.0 mm to 45.0 mm) were confirmed by pathology and routine ultrasound and ARFI examination. With the pathological results as the“gold standard”, they were divided into 4 groups:3.0-10.0 mm, 11.0-20.0 mm, 21.0-30.0 mm and 31.0-45.0 mm according to the diameter of the nodules. According to the cut off value of VTQ-SWV in the diagnosis of thyroid nodules, ROC curves among the four groups of nodules with different diameters were analyzed. Results The total coincidence rate of VTQ-SWV was 72.14% in nodules with diameter ranging from 11.0 mm to 20.0 mm. In the group of 3.0-10.0 mm in diameter, the total coincidence rate was the lowest(13.56%). ROC analysis showed that in 3.0-10.0 mm group, the area under the curve(AUC) was 0.651, and the sensitivity and specificity were 59.1% and 67.6% respectively when the cut off value was 2.29 m/s. In 11.0-20.0 mm group,the area under the curve was 0.883, and when the cut off value of VTQ-SWV was 3.23 m/s, the sensitivity and specificity were 83.0% and 89.7%, respectively. In 21.0-30.0 mm group, the area under the curve was 0.777, and when the cut off value of VTQ-SWVwas 2.76 m/s, the sensitivity and specificity were 80.4% and 74.4%, respectively. In 31.0-45.0 mm group, the area under the curve was 0.720, and when the cut off value of benign and malignant VTQ-SWV was 3.35 m/s,the sensitivity and specificity were 68.7% and 77.6% respectively. Conclusion VTQ-SWV is the most valuable technique in the differential diagnosis of benign and malignant thyroid nodules with diameters ranging from 10.0 mm to30.0 mm. VTQ-SWV of thyroid nodules in the diameter range of 31.0 mm to 45.0 mm has certain guiding significance for biopsy.
作者
邵春晖
李秀昌
李培英
向然
SHAO Chun-hui;LI Xiu-chang;LI Pei-ying;XIANG Ran(Department of Ultrasound,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;Second Affiliated Hospital of Shandong First Medical University,Taian 271000,Shandong,CHINA)
出处
《海南医学》
CAS
2022年第2期210-215,共6页
Hainan Medical Journal
关键词
甲状腺结节
直径范围
声触诊组织定量
剪切波速度
鉴别诊断
Thyroid nodules
Diameter range
Virtual touch tissue quantification
Shear wave velocity
Differential diagnosis
