CAJ | 학술논문

目的探讨声脉冲辐射力成像(ARFI)在甲状腺低回声小结节鉴别诊断中的应用价值.方法应用声触诊组织成像(VTI)及声触诊组织量化(VTQ)技术分析经病理证实的31例患者44个直径≤1 cm的甲状腺低回声结节的ARFI图像特征.通过VTI图像对甲状腺低回声结节进行硬度评分,计算结节VTI图像与灰阶图像面积比.以病理诊断为金标准,分别绘制VTI评分、面积比及VTQ值诊断甲状腺恶性结节的ROC曲线,找出VTI评分、面积比及VTQ值诊断恶性结节的最佳截点.结果经ROC曲线检验,以VTI评分3分为截点诊断甲状腺恶性结节的敏感性96.0％,特异性94.7％.VTI评分＞3分的结节34个,包括良性9个,恶性25个.VTI评分≤3分结节10个,均为良性.甲状腺恶性结节VTI图像与灰阶图像面积比高于良性结节(1.58±0.18对1.30±0.10,P＜0.05),以面积比1.47为截点诊断甲状腺恶性结节的敏感性80.0％,特异性94.7％.以VTQ值2.76 m/s为截点诊断甲状腺恶性结节的敏感性88.0％,特异性94.7％.结论 ARFI技术可提供甲状腺结节硬度信息,对甲状腺低回声小结节的鉴别诊断具有较高的应用价值.
목적 탐토성맥충복사력성상(ARFI)재갑상선저회성소결절감별진단중적응용개치.방법 응용성촉진조직성상(VTI)급성촉진조직양화(VTQ)기술분석경병리증실적31례환자44개직경≤1 cm적갑상선저회성결절적ARFI도상특정.통과VTI도상대갑상선저회성결절진행경도평분,계산결절VTI도상여회계도상면적비.이병리진단위금표준,분별회제VTI평분、면적비급VTQ치진단갑상선악성결절적ROC곡선,조출VTI평분、면적비급VTQ치진단악성결절적최가절점.결과 경ROC곡선검험,이VTI평분3분위절점진단갑상선악성결절적민감성96.0％,특이성94.7％.VTI평분＞3분적결절34개,포괄량성9개,악성25개.VTI평분≤3분결절10개,균위량성.갑상선악성결절VTI도상여회계도상면적비고우량성결절(1.58±0.18대1.30±0.10,P＜0.05),이면적비1.47위절점진단갑상선악성결절적민감성80.0％,특이성94.7％.이VTQ치2.76 m/s위절점진단갑상선악성결절적민감성88.0％,특이성94.7％.결론 ARFI기술가제공갑상선결절경도신식,대갑상선저회성소결절적감별진단구유교고적응용개치.
Objective To investigate the applicative value of acoustic radiation force impulse imaging (ARFI) in the differential diagnosis of small hypoechoic thyroid nodules.Methods 31 patients were pathologically confirmed as having a total of 44 small hypoechoic thyroid nodules ≤ 1 cm in diameter,followed by analyses of the characteristics of their ARFI images,including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ).Based on VTI images of the nodules,the hardness of small hypoechoic thyroid nodules was respectively scored,and the ratios of VTI images to gray scale image areas were calculated.With pathological diagnosis as the gold standard,VTI scores,area ratios and VTQ values of the ROC curve in diagnosis of thyroid malignant nodules were sketched so as to explore the optimal cut-off points in VTI scores,area ratios and VTQ values in the diagnosis of malignant nodules.Results By the ROC curve test,VTI score of 3 was determined as the cut-off point of areas ratio,with the sensitivity and specificity of diagnosing thyroid cancer being 96.0 ％ and 94.7％,respectively.There were 34 nodules with VTI score greater than 3 (including 9 benign nodules and 25 malignant nodules) and 10 nodules with VTI score of 3 or less (all benign nodules).Malignant thyroid nodules had higher ratio of VTI images to gray scale image area than that of the benign nodules (1.58 ± 0.18 vs 1.30 ± 0.10,P ＜0.05).When 1.47 was set as the cut-off point of areas ratio,the sensitivity and specificity of diagnosing thyroid cancer were 80.0％ and 94.7％,respectively.The VTQ value of 2.76 m/s in diagnosis of thyroid malignant nodules was designated as the cut-off point,with a sensitivity of 88.0 ％,specificity of 94.7 ％.Conclusions The ARFI technique is able to provide information of thyroid nodule hardness,which guarantees its high applicative value in the differential diagnosis of small hypoechoic thyroid nodules.