声触弹性成像评估甲状腺结节良恶性的价值
|
摘要
目的:探讨声触弹性成像(STE)在鉴别良、恶性甲状腺结节的应用价值。方法:对50例甲状腺结节患者术前行STE检查,记录病灶及其周边区域(Shell区)的杨氏模量均值(Emean),比较甲状腺良性结节和恶性结节病灶区及Shell区的Emean,评价STE技术对甲状腺结节良恶性的诊断效能。结果:恶性甲状腺结节病灶区及Shell区的Emean均较良性结节升高,并以Shell区升高更明显,差异具有统计学意义(P <0. 05);恶性甲状腺结节病灶及其Shell区Emean诊断临界值分别取23. 92 k Pa和26. 23 k Pa,诊断灵敏度分别为81. 3%和90. 6%,特异度分别为55. 6%及61. 1%。结论:STE对鉴别甲状腺结节良恶性有一定的临床价值,并且Shell区的诊断价值高于病灶区。
Objective: To evaluate value of sound touch elastography( STE) in the differential diagnosis of benign and malignant thyroid lesions. Methods: STE was performed on 50 Patients with thyroid nodules. Lesions,its shell and the mean value of Young's modulus( Emean) of shell areas were recorded. The Emeans of the benign thyroid nodules,malignant nodules and the shell areas were compared to evaluate the diagnostic efficacy of STE technique for the benign and malignant thyroid nodules. Results: Emeans in the lesion area and the Shell of malignant thyroid nodules were higher than those in benign nodules,and increased in the Shell. The difference was statistically significant( P <0. 05). ROC curve analysis showed that the diagnostic threshold of Emeans of The malignant thyroid nodule lesion and its Shell was 23. 92 kPa and 26. 23 kPa,respectively. The diagnostic sensitivities were 81. 3% and 90. 6%,respectively,and the specificities were 55. 6% and 61. 1%,respectively.Conclusion: STE has certain clinical value in distinguishing benign and malignant thyroid nodules,and the diagnostic value in Shell area is higher than that in lesion area.
Objective: To evaluate value of sound touch elastography( STE) in the differential diagnosis of benign and malignant thyroid lesions. Methods: STE was performed on 50 Patients with thyroid nodules. Lesions,its shell and the mean value of Young's modulus( Emean) of shell areas were recorded. The Emeans of the benign thyroid nodules,malignant nodules and the shell areas were compared to evaluate the diagnostic efficacy of STE technique for the benign and malignant thyroid nodules. Results: Emeans in the lesion area and the Shell of malignant thyroid nodules were higher than those in benign nodules,and increased in the Shell. The difference was statistically significant( P <0. 05). ROC curve analysis showed that the diagnostic threshold of Emeans of The malignant thyroid nodule lesion and its Shell was 23. 92 kPa and 26. 23 kPa,respectively. The diagnostic sensitivities were 81. 3% and 90. 6%,respectively,and the specificities were 55. 6% and 61. 1%,respectively.Conclusion: STE has certain clinical value in distinguishing benign and malignant thyroid nodules,and the diagnostic value in Shell area is higher than that in lesion area.
引文
[1]PASCHOU S A,VRYONIDOU A,GOULIS D G. Adrenal incidentalomas:a guide to assessment,treatment and follow-up[J]. Maturitas,2016,92:79-85.
[2]庞玉娟. c N0甲状腺乳头状癌颈部淋巴结转移的危险因素分析[D].唐山:华北理工大学,2017.
[3]施燕芸,戚庭月.超声弹性成像在甲状腺结节中的应用进展[J].医学综述,2017,23(10):2035-2040.
[4]杨磊,陈茂山,杨宏伟,等. 1706名医院职工甲状腺超声体检结果分析[J].遵义医学院学报,2018,41(4):473-476.
[5]深圳迈瑞生物医疗电子股份有限公司. STE弹性成像超声弹性成像的全新解决方案[J].中国超声医学杂志,2017,33(5):482-483.
[6]张桂桃.超声新技术对甲状腺良恶性结节的鉴别诊断价值[J].中西医结合心血管病电子杂志,2018,6(25):25.
[7]费腾.甲状腺癌超声造影诊断研究[D].上海:上海交通大学,2015.
[8]牟泳霖,曹军英,里子彧,等.实时剪切波弹性成像技术对甲状腺良恶性结节鉴别研究[J].临床军医杂志,2018,46(9):1030-1032.
[9]LIN P,CHEN M,LIU B,et al. Diagnostic performance of shear wave elastography in the identification of malignant thyroid nodules:a meta-analysis[J]. European Radiology,2014,24(11):2729-2738.
[10]高飞,陈天君,阮骊韬.剪切波弹性成像在甲状腺癌中的研究进展[J].医学综述,2017,23(15):3092-3096.
[11]吴淮宇,董发进,徐金锋.超声弹性成像预测浸润性乳腺癌的研究进展[J].医学综述,2018,24(14):2850-2854.
[12]章瑾,钱纪江,刘祖平.“Shell”区弹性应变率检测对甲状腺结节良恶性的评估[J].浙江实用医学,2012,17(6):432-433.
[13]张璐璐. TGF-β1和IGF-1在不同甲状腺结节中的表达及其临床意义[D].郑州:郑州大学,2018.
[14]梁慧玲,贺晓燕,杨文秀,等. TRAP1蛋白在甲状腺乳头状癌中的表达及意义[J].贵州医科大学学报,2017,42(12):1407-1411.
[15]American Thyroid Association. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2009,19(11):1167-1214.
[2]庞玉娟. c N0甲状腺乳头状癌颈部淋巴结转移的危险因素分析[D].唐山:华北理工大学,2017.
[3]施燕芸,戚庭月.超声弹性成像在甲状腺结节中的应用进展[J].医学综述,2017,23(10):2035-2040.
[4]杨磊,陈茂山,杨宏伟,等. 1706名医院职工甲状腺超声体检结果分析[J].遵义医学院学报,2018,41(4):473-476.
[5]深圳迈瑞生物医疗电子股份有限公司. STE弹性成像超声弹性成像的全新解决方案[J].中国超声医学杂志,2017,33(5):482-483.
[6]张桂桃.超声新技术对甲状腺良恶性结节的鉴别诊断价值[J].中西医结合心血管病电子杂志,2018,6(25):25.
[7]费腾.甲状腺癌超声造影诊断研究[D].上海:上海交通大学,2015.
[8]牟泳霖,曹军英,里子彧,等.实时剪切波弹性成像技术对甲状腺良恶性结节鉴别研究[J].临床军医杂志,2018,46(9):1030-1032.
[9]LIN P,CHEN M,LIU B,et al. Diagnostic performance of shear wave elastography in the identification of malignant thyroid nodules:a meta-analysis[J]. European Radiology,2014,24(11):2729-2738.
[10]高飞,陈天君,阮骊韬.剪切波弹性成像在甲状腺癌中的研究进展[J].医学综述,2017,23(15):3092-3096.
[11]吴淮宇,董发进,徐金锋.超声弹性成像预测浸润性乳腺癌的研究进展[J].医学综述,2018,24(14):2850-2854.
[12]章瑾,钱纪江,刘祖平.“Shell”区弹性应变率检测对甲状腺结节良恶性的评估[J].浙江实用医学,2012,17(6):432-433.
[13]张璐璐. TGF-β1和IGF-1在不同甲状腺结节中的表达及其临床意义[D].郑州:郑州大学,2018.
[14]梁慧玲,贺晓燕,杨文秀,等. TRAP1蛋白在甲状腺乳头状癌中的表达及意义[J].贵州医科大学学报,2017,42(12):1407-1411.
[15]American Thyroid Association. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2009,19(11):1167-1214.