助力式弹性成像与声触诊组织成像和定量法对甲状腺良恶性结节诊断价值的比较
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摘要
目的比较助力式弹性成像(EI)与声触诊组织成像和定量(VTIQ)技术对甲状腺良恶性结节的鉴别诊断价值,探讨影响结果准确性的因素。方法对拟行甲状腺结节手术的62例患者行常规超声、EI及VTIQ检查,EI模式下对应变图进行弹性评分,测量结节及周围正常组织的应变率,计算应变指数(SI),VTIQ模式下获取病灶内剪切波速度。结果 62例患者中,40例为恶性,22例为良性。应变图评分≥3分视为恶性时,EI评分法诊断甲状腺结节性质的灵敏度为90.00%,特异度为31.82%,准确度为69.32%;受试者工作特征曲线分析结果显示EI-SI及VTIQ诊断甲状腺结节的曲线下面积分别为77.8%(95%CI:0.64～0.91)(P=0.000)和74.3%(95%CI:0.62～0.87)(P=0.002)。EI评分法诊断的准确性受甲状腺结节大小(P=0.04)及位置(P=0.02)影响,SI法及VTIQ结果的准确性不受结节特征(P>0.05)影响。结论 EI评分法对甲状腺结节诊断的准确率与结节特征相关,与半定量SI及定量VTIQ相互补充可有效提高诊断能力。
Objective To compare the values of elasticity imaging(EI)and Virtual Touch~(TM) tissue imaging and quantification(VTIQ)in diagnosing thyroid nodules and explore the factors influencing the accuracy of these two techniques.Methods Totally 62 patients who were planned to receive surgery for thyroid nodules underwent conventional ultrasound,EI,and VTIQ examinations.EI patterns were scored according to the degree and distribution of strain,the strain of nodule and surrounding normal reference tissue were measured,and then strain index was calculated.Shear wave velocity in nodules were obtained under VTIQ mode.Results The nodules were malignant in 40 patients and benign in 22 patients.When the strain score of 3 was regarded as malignant,the diagnostic sensitivity,specificity,and accuracy of EI in detecting thyroid nodules were 90.00%,31.82%,and 69.32%,respectively.Receiver operating characteristic curve results showed that the area under curves of EI-SI and VTIQ methods for diagnosing thyroid nodules was 77.8%(95%CI:0.64-0.91)(P=0.000)and 74.3%(95%CI:0.62-0.87)(P=0.002),respectively.Thyroid nodules' characteristics location(P=0.04)and size(P=0.02)were correlated with the diagnostic accuracy of EI.The accuracy of SI and VTIQ were not affected by thyroid nodules' characteristics(P>0.05).Conclusions The diagnostic accuracy of EI for thyroid nodules is related to nodules' characteristics.EI combined with semi-quantitative SI and quantitative VTIQ can effectively improve the diagnostic capability for thyroid nodules.
Objective To compare the values of elasticity imaging(EI)and Virtual Touch~(TM) tissue imaging and quantification(VTIQ)in diagnosing thyroid nodules and explore the factors influencing the accuracy of these two techniques.Methods Totally 62 patients who were planned to receive surgery for thyroid nodules underwent conventional ultrasound,EI,and VTIQ examinations.EI patterns were scored according to the degree and distribution of strain,the strain of nodule and surrounding normal reference tissue were measured,and then strain index was calculated.Shear wave velocity in nodules were obtained under VTIQ mode.Results The nodules were malignant in 40 patients and benign in 22 patients.When the strain score of 3 was regarded as malignant,the diagnostic sensitivity,specificity,and accuracy of EI in detecting thyroid nodules were 90.00%,31.82%,and 69.32%,respectively.Receiver operating characteristic curve results showed that the area under curves of EI-SI and VTIQ methods for diagnosing thyroid nodules was 77.8%(95%CI:0.64-0.91)(P=0.000)and 74.3%(95%CI:0.62-0.87)(P=0.002),respectively.Thyroid nodules' characteristics location(P=0.04)and size(P=0.02)were correlated with the diagnostic accuracy of EI.The accuracy of SI and VTIQ were not affected by thyroid nodules' characteristics(P>0.05).Conclusions The diagnostic accuracy of EI for thyroid nodules is related to nodules' characteristics.EI combined with semi-quantitative SI and quantitative VTIQ can effectively improve the diagnostic capability for thyroid nodules.
引文
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[9] Szczepanek-Parulska E,Woliński K,Stangierski A,et al.Biochemical and ultrasonographic parameters influencing thyroid nodules elasticity [J].Endocrine,2014,47(2):519- 527.DOI:10.1007/s12020- 014- 0197-y.
[2] Rubaltelli L,Corradin S,Dorigo A,et al.Differential diagnosis of benign and malignant thyroid nodules at elastosonography [J].Ultraschall Med,2009,30(2):175- 179.DOI:10.1055/s- 2008- 1027442.
[3] Friedrich-Rust M,Vorlaender C,Dietrich CF,et al.Evaluation of strain elastography for differentiation of thyroid nodules:results of a prospective DEGUM multicenter study [J].Ultraschall Med,2016,37(3):262- 270.DOI:10.1055/s- 0042- 104647.
[4] Borysewicz-Sanczyk H,Dzieciol J,Sawicka B,et al.Practical application of elastography in the diagnosis of thyroid nodules in children and adolescents [J].Horm Res Paediatr,2016,86(1):39- 44.DOI:10.1159/000447490.
[5] Guazzaroni M,Spinelli A,Coco I,et al.Value of strain-ratio on thyroid real-time sonoelastography[J].Radiol Med,2014,119(3):149- 155.DOI:10.1007/s11547- 013- 0320- 9.
[6] Giusti M,Orlandi D,Melle G,et al.Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules[J].J Zhejiang Univ Sci B,2013,14(3):195- 206.DOI:10.1631/jzus.B1200106.
[7] Chang JM,Moon Wk,Cho N,et al.Breast mass evaluation:factors influencing the quality of US elastography [J].Radiology,2011,259(1):59- 64.DOI:10.1148/radiol.10101414.
[8] Kim MH,Si L,Sun HK,et al.Thyroid nodule parameters influencing performance of ultrasound elastography using intrinsic compression [J].Ultrasound Med Biol,2015,41(9):2333- 2339.DOI:10.1016/j.ultrasmedbio.2015.05.002.
[9] Szczepanek-Parulska E,Woliński K,Stangierski A,et al.Biochemical and ultrasonographic parameters influencing thyroid nodules elasticity [J].Endocrine,2014,47(2):519- 527.DOI:10.1007/s12020- 014- 0197-y.