CAJ | 학술논문

目的探讨实时剪切波弹性成像(shear wave elastography,SWE)技术在甲状腺微小癌(thyroid micro carcinoma,TMC)诊断中的应用价值.方法 2014年6 - 12月于我院行超声检查发现甲状腺微小结节(常规超声可疑恶性)的门诊患者,应用剪切波弹性成像技术测量其中62例共67个甲状腺微小结节(≤1.0 cm)杨氏模量值,以组织穿刺活检的病理结果为诊断金标准构建ROC曲线,评价SWE定量测值在甲状腺微小癌诊断方面的价值.结果共分析≤1.0 cm的甲状腺结节67个, TMC 37个,良性30个.TMC表现的最大、平均杨氏模量值分别为(58.47±31.51) kPa、(41.58±23.36)kPa;微小良性结节表现的最大、平均杨氏模量值分别为(26.94±14.31) kPa、(18.03±10.83) kPa,TMC的最大、平均杨氏模量值均高于甲状腺良性微小结节,两者差异有统计学意义(最大值t=5.063,P=0.000;平均值t=4.591,P=0.000).以甲状腺微小结节的杨氏模量值最大值40 kPa为临界值时,诊断良恶性病变的敏感度为84.3%,特异度为91.2%;以平均值35 kPa为临界值时,诊断良恶性病变的敏感度为80.0%,特异度为94.2%.ROC曲线下面积为0.942、0.923(P<0.05).结论 SWE可以定量测定甲状腺微小癌结节的杨氏模量值的硬度,有助于甲状腺微小癌的鉴别诊断.
목적 탐토실시전절파탄성성상(shear wave elastography,SWE)기술재갑상선미소암(thyroid micro carcinoma,TMC)진단중적응용개치.방법 2014년6 - 12월우아원행초성검사발현갑상선미소결절(상규초성가의악성)적문진환자,응용전절파탄성성상기술측량기중62례공67개갑상선미소결절(≤1.0 cm)양씨모량치,이조직천자활검적병리결과위진단금표준구건ROC곡선,평개SWE정량측치재갑상선미소암진단방면적개치.결과 공분석≤1.0 cm적갑상선결절67개, TMC 37개,량성30개.TMC표현적최대、평균양씨모량치분별위(58.47±31.51) kPa、(41.58±23.36)kPa;미소량성결절표현적최대、평균양씨모량치분별위(26.94±14.31) kPa、(18.03±10.83) kPa,TMC적최대、평균양씨모량치균고우갑상선량성미소결절,량자차이유통계학의의(최대치t=5.063,P=0.000;평균치t=4.591,P=0.000).이갑상선미소결절적양씨모량치최대치40 kPa위림계치시,진단량악성병변적민감도위84.3%,특이도위91.2%;이평균치35 kPa위림계치시,진단량악성병변적민감도위80.0%,특이도위94.2%.ROC곡선하면적위0.942、0.923(P<0.05).결론 SWE가이정량측정갑상선미소암결절적양씨모량치적경도,유조우갑상선미소암적감별진단.
Objective To explore the value of real-time shear wave elastography (SWE) in diagnosis of thyroid micro carcinoma (TMC).Methods Out-patients with thyroid small nodule suspected malignant who underwent ultrasound examination from June 2014 to December 2014 in our hospital were enrolled in this study. Sixty-seven nodules (≤1.0 cm) in 62 patients were examined by SWE to get the Young's modulus. Pathologic results were served as the golden standard to construct the ROC curves, and the value of SWE in diagnosis of TMC was evaluated.Results Of the 67 nodules, 37 were TMC and 30 were benign. The maximum and mean elasticity value of TMC were (58.47±31.51) kPa and (41.58±23.36) kPa, while the maximum and mean elasticity value of the micro benign nodules were (26.94±14.31) kPa and (18.03±10.83) kPa, which weresignificantly lower than those of TMC (t = 5.063,P = 0.000;t = 4.591,P=0.000); Taking 40 kPa as the threshold of the maximum elasticity value, the sensitivity was 84.3% and the specificity was 91.2%. Taking 35 kPa as the threshold of the mean elasticity value, the sensitivity was 80.0% and the specificity was 94.2%. The area under the ROC curve of the maximum, mean elasticity value was 0.942, 0.923 (P<0.05).Conclusion SWE can be used for the quantitative determination of thyroid micro carcinoma hardness, and it is helpful in differential diagnosis of thyroid micro carcinoma.