| 摘要: |
| 目的 探讨实时剪切波弹性成像(SWE)定量技术对甲状腺良恶性结节的诊断价值及其对恶性结节侵袭性的预测 方法 回顾性分析230例行实时剪切波弹性成像并经手术病理证实的甲状腺结节患者,绘制ROC曲线,确定诊断甲状腺良恶性结节杨氏模量诊断截断值；对其中122例甲状腺癌患者按有无颈部淋巴结转移分类,与结节大小、年龄、性别、 Emean,Emax,Eratio值进行Logistic回归,分析实时剪切波弹性成像杨氏模量值与甲状腺恶性结节颈部淋巴结转移的相关性。结果230例甲状腺良恶性结节,整体比较,良性结节组SWE杨氏模量值均小于恶性结节组,除Emin值差异不具有统计学意义外(P＞0.05),其余三者之间的差距均具有统计学意义(P＜0.05)。Emax、Emean、Eratio三者诊断甲状腺良恶性结节的截断值分别为57Kpa、39Kpa、2.7,相应的曲线下面积分别为0.877,0.776,0.866。Emax值诊断甲状腺结节良恶性曲线下面积最大。甲状腺恶性结节颈部淋巴结转移与结节大小、Emax值、Eratio值有关(P＜0.05),随着结节大小增加,Emax值和Eratio值的增大,颈部淋巴结转移相应可能增加,且转移淋巴结多数都位于中央区。结论 杨氏模量值Emax、Emean、Eratio值对鉴别甲状腺结节良恶性有意义,其中Emax值在鉴别诊断甲状腺结节良恶性时诊断效能最高。Emax值、Eratio值可作为甲状腺恶性结节侵袭性的预测因子,Emax值、Eratio值越大,合并淋巴结转移的几率增大,甲状腺恶性结节的侵袭性越高。 |
| 关键词: 实时剪切波弹性成像技术 杨氏模量值 甲状腺结节 侵袭性 |
| DOI： |
| 投稿时间：2020-03-20修订日期：2020-11-23 |
| 基金项目:] 国家自然科学基金青年科学(81701717)。 |
|
| The value of SWE quantitative technique in the diagnosis of benign and malignant thyroid nodules, and a preliminary study of the prediction of the invasiveness of malignant nodulesCheng Liang Shaanxi Provincial People"s Hospital,Xi’an 710068,China |
| Luxin,Limiao,Zhouqi |
| () |
| Abstract: |
| Objective Discuss the value of SWE quantitative technique in the diagnosis of thyroid benign and malignant nodules and its prediction of invasiveness of malignant nodules. Method A retrospective analysis of 230 patients with thyroid nodules confirmed by surgical pathology and real time shear wave elastography.Draw the ROC curve,To determine the diagnostic value of Young’s modulus for diagnosis of benign and malignant thyroid nodules;Of which 122 cases of thyroid cancer patients according to whether cervical lymph node metastasis and Emax classification, nodule size, age, gender, Emean, and Eratio values were Logistic regression analysis of real-time shear wave elastography Young’s modulus correlation with malignant cervical lymph node metastasis of thyroid nodules. Result 230 cases of benign and malignant thyroid nodules, compared with the whole group, the SWE Young’s modulus of benign nodules group was lower than that of malignant nodules group, except for Emin value difference was not statistically significant (P > 0.05). The difference between the other three groups was statistically significant (P < 0.05). The cut-off values of Emax, Emean and Eratio in diagnosis of benign and malignant thyroid nodules were 57Kpa, 39Kpa and 2.7, respectively. The corresponding area under the curve was 0.877, 0.776, 0.866, respectively. The three cases were diagnosed as benign and malignant thyroid nodules. The value of Emax was the largest in the diagnosis of thyroid nodules under the benign and malignant curves. Malignant thyroid nodules of cervical lymph node metastasis and nodule size, Emax value, Eratio value (P < 0.05), with the Emax value increasing nodule size increased, and Eratio value of the cervical lymph node metastasis in corresponding lymph node metastasis may increase, and most are located in the central area. Conclusion The values of Emax, Emean and Eratio were significant for differentiating benign and malignant thyroid nodules, and Emax value was the highest in differential diagnosis of benign and malignant thyroid nodules. Emax value and Eratio value can be used as predictors of invasion of thyroid malignant nodules. The greater the Emax and Eratio values, the higher the probability of lymph node metastasis, the higher the invasiveness of thyroid malignant nodules. |
| Key words: |
