CAJ | 학술논문

目的:应用ARFI对甲状腺结节的硬度进行评估,探讨ARFI在鉴别诊断甲状腺良恶性结节中的应用价值.方法:采用ARFI对90例患者102个甲状腺结节(75个良性,27个恶性)进行检查,获取并分析甲状腺良恶性结节的声触诊组织定量(virtual touch tissue quantication,VTQ)值.通过绘制ROC曲线获得VTQ值的曲线下面积以及最佳截断点,评价其诊断效能.所有病例均经病理证实.结果:恶性结节VTQ值中位数为3.04 m/s,平均(3.43±1.13)m/s,范围2.25~6.90 m/s;良性结节中位数为2.10 m/s,平均(2.08±0.62)m/s,范围0.72~4.24 m/s;甲状腺结节周边组织的中位数为1.91 m/s,平均(1.95±0.377)m/s,范围1.23~2.38 m/s.甲状腺恶性结节VTQ值要明显高于甲状腺良性结节,比较差异具有统计学意义(P<0.001),甲状腺良性结节与周边正常甲状腺组织之间比较,差异无统计学意义(P>0.05).当VTQ截断点为2.60 m/s时,其预测甲状腺恶性结节的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为87.0%、88.7%、87.3%、70.6%、95.6%.结论:ARFI可显著提高甲状腺良恶性结节的鉴别诊断能力,是一项很有发展前景的诊断技术.
목적:응용ARFI대갑상선결절적경도진행평고,탐토ARFI재감별진단갑상선량악성결절중적응용개치.방법:채용ARFI대90례환자102개갑상선결절(75개량성,27개악성)진행검사,획취병분석갑상선량악성결절적성촉진조직정량(virtual touch tissue quantication,VTQ)치.통과회제ROC곡선획득VTQ치적곡선하면적이급최가절단점,평개기진단효능.소유병례균경병리증실.결과:악성결절VTQ치중위수위3.04 m/s,평균(3.43±1.13)m/s,범위2.25~6.90 m/s;량성결절중위수위2.10 m/s,평균(2.08±0.62)m/s,범위0.72~4.24 m/s;갑상선결절주변조직적중위수위1.91 m/s,평균(1.95±0.377)m/s,범위1.23~2.38 m/s.갑상선악성결절VTQ치요명현고우갑상선량성결절,비교차이구유통계학의의(P<0.001),갑상선량성결절여주변정상갑상선조직지간비교,차이무통계학의의(P>0.05).당VTQ절단점위2.60 m/s시,기예측갑상선악성결절적민감성、특이성、준학성、양성예측치、음성예측치분별위87.0%、88.7%、87.3%、70.6%、95.6%.결론:ARFI가현저제고갑상선량악성결절적감별진단능력,시일항흔유발전전경적진단기술.
Objective:To evaluate the tissue stiffness of thyroid nodules by ARFI to differentiate benign from malignant thyroid lesions. Method:The ARFI technique was performed in 90 patients with 102 thyroid nodules(75 benign,27 malignant). The values of virtual touch tissue quantication (VTQ)were obtained and analyzed. The area under the curve and cut-off point,both of which were obtained by using a receiver operating characteristic curve analysis,were used to assess diagnostic performance. Final diagnosis was established by histopathology. Result:The VTQ median value of malignant nodules,a benign nodules,and the surrounding thyroid parenchyma was 3.04 m/s,mean(3.43±1.13)m/s,range 2.25-6.90 m/s,2.10 m/s,mean (2.08±0.62)m/s,range 0.72-4.24 m/s,1.91 m/s,mean(1.95±0.377)m/s,range 1.23-2.38 m/s,respectively. The VTQ of thyroid malignant nodules was significant higher than that of the benign thyroid nodules. There were statistical differences between malignant and benign nodules(P<0.001). With a cut-off value of 2.60 m/s for VTQ value,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value for malignancy was 87.0%,88.7%,87.3%,70.6%,and 95.6%,respectively. Conclusion:ARFI can significantly improve diagnosis ability in the differentiation between benign and malignant thyroid nodules,which became a very promising diagnostic technique.