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实时剪切波弹性成像对甲状腺结节良恶性的诊断价值
作者:周正国1  刘牛1  朱正球1  吴晓斌2  吴意赟1  许华宁1  宋旭光1  蔡婷1 
单位:1. 南京中医药大学附属医院 超声医学科, 江苏 南京 210029;
2. 南京中医药大学附属医院 病理科, 江苏 南京 210029
关键词:超声弹性成像 实时剪切波弹性成像 甲状腺结节 
分类号:R445.1;R653
出版年·卷·期(页码):2017·36·第三期(453-456)
摘要:

目的:探讨实时剪切波弹性成像(RT-SWE)技术在甲状腺结节良恶性诊断中的应用价值。方法:对173例病人的188个甲状腺结节进行RT-SWE检查,获取病灶的弹性指标平均值、最小值、最大值(SWE-Mean、SWE-Min、SWE-Max),并用受试者工作特征曲线(ROC曲线)比较各弹性指标在鉴别甲状腺结节良恶性中的应用价值。结果:188个甲状腺结节中,经病理证实良性104个,恶性84个。ROC曲线显示RT-SWE杨氏模量指标SWE-Mean、SWE-Min、SWE-Max曲线下面积分别为0.903、0.782及0.878,SWE-Mean指标鉴别甲状腺良恶性明显要优于SWE-Min及SWE-Max。该方法敏感性为79.8%,特异性为90.4%,并据约登指数确定RT-SWE SWE-Mean阈值为27.85 kPa。结论:RT-SWE杨氏模量平均值在鉴别甲状腺结节良恶性中具有很好的应用价值。

Objective:To evaluate diagnostic performance of shear wave elastography in distinguishing malignant from benign thyroid nodules. Methods:A total of 173 patients with 188 thyroid nodules underwent SWE examination to obtain the parameters of SWE-mean, SWE-min and SWE-max. SWE parameter and optimal cut-off value were calculated using receiver operating characteristic(ROC)curve. Results:One hundred and four benign nodules and 84 malignant nodules were confirmed by cytology or histology in the total of 188 thyroid nodules. The AUC of the three SWE parameters(SWE-mean, SWE-min and SWE-max)was 0.903, 0.782 and 0.878 respectively. The parameter of SWE-mean was much better in the differentiation of benign from malignant thyroid nodules. The optimal cut-off value of SWE-mean as 27.85 kPa achieved a sensitivity of 79.8% and a specificity of 90.4%, and the Youden index was the biggest. Conclusion:The SWE-mean parameter is helpful for the identification of malignant and benign thyroid nodules.

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