影像诊断与介入放射学

目的探讨声触诊组织量化成像(VTIQ)剪切波弹性成像技术对不同大小的甲状腺实性结节良恶性鉴别的诊断价值。方法回顾性分析经手术后病理证实的50例患者62个甲状腺实性病灶的常规超声与VTIQ图像资料。先行常规超声检查,对二维超声图像特征进行描述。然后根据病灶大小(≤10 mm和>10 mm)分为两组,测量良恶性病灶及周边组织在VTIQ上的剪切波速度(SWV),绘制受试者操作特性(ROC)曲线,曲线下面积(AUC)进行组间比较,分析评估VTIQ鉴别甲状腺实性病灶良恶性的诊断价值。结果 62个甲状腺病灶中,恶性病灶32个,良性病灶30个。良性病灶与其周边组织的SWV差异无统计学意义(P=0.355),恶性病灶SWV明显高于其周边组织SWV值(P=0.000);良恶性病灶周边组织的SWV差异无统计学意义(P=0.164)。≤10 mm的病灶AUC为0.951,鉴别良恶性SWV截断值为2.53 m/s时,准确性85.7%,灵敏度91.3%,特异度75.0%,阳性预测值87.5%,阴性预测值81.8%,优势比31.5。>10 mm的病灶AUC为0.784,鉴别良恶性SWV截断值为2.56m/s时,准确性77.8%,灵敏度88.9%,特异度77.2%,阳性预测值61.5%,阴性预测值92.8%,优势比20.8。结论 VTIQ对鉴别甲状腺实性良恶性病灶有一定诊断价值,尤其是对≤10 mm的病灶。

Objective To evaluate virtual touch tissue quantification(VTTQ) for differentiating benign and malignant thyroid nodules.Methods 50 patients with 62 pathologically proven benign(30) and malignant(32) thyroid nodules underwent conventional ultrasound and VTIQ examinations.The nodules were divided into two groups of ≤10 mm and >10 mm.Shear wave velocities(SWVs) of benign and malignant nodules and surrounding tissues were measured.The receiver operating characteristic curve(ROC) was used to assess the value of VTIQ in differentiating benign and malignant nodules.Areas under the curve(AUC) were compared between the two groups.Results The SWVs between benign nodules and surrounding tissues,between surrounding tissue of benign and malignant nodules were not significantly different(P=0.355,0.164) whereas the SWVs of malignant nodules were significantly higher than that of surrounding tissues(P=0).The AUC were 0.951 for nodules ≤10 mm and 0.784 for nodules >10 mm.At SWV cut-off values of 2.53 m/s for nodules ≤10 mm and 2.56 m/s for nodules >10 mm,the accuracy was 85.7% and 77.8%,sensitivity was 91.3% and 88.9%,specificity was 75.0% and 77.2%,positive predictive value was 87.5% and 61.5%,negative predictive value was 81.8% and 92.8%,odds ratio was 31.5 and 20.8,respectively.Conclusion VTIQ is valuable in differentiating benign from malignant thyroid nodules.