实时剪切波弹性成像在甲状腺K-TIRADS 3-5类结节诊断中的应用价值
|
摘要
目的:探讨实时剪切波弹性成像(shear wave elastography,SWE)在K-TIRADS 3-5类甲状腺结节诊断中的应用价值。方法:回顾性分析K-TIRADS 3-5类之间的甲状腺手术患者,探讨实时SWE技术在其中的诊断价值,筛选出效能最佳的定量弹性指标,得出诊断界值。结果:入组244例患者289个结节,其中恶性结节170个,良性结节119个。结节病灶区的杨氏模量最大值E_(max)是用于鉴别结节性质效能最佳的指标,AUC为0. 764,P <0. 001,且E_(max)=52. 7 kPa时鉴别K-TIRADS 3-5类结节良恶性的敏感度、特异度分别为75. 3%、73. 1%。结论:实时SWE技术可用于K-TIRADS 3-5类甲状腺结节的鉴别,E_(max)是诊断效能最佳的定量弹性指标。
Objective: To evaluate the utility of shear wave elastography( SWE) in diagnosing K-TIRADS 3-5 category thyroid nodules. Methods: A group of 289 thyroid nodules with K-RADS 3-5 category were enrolled in our research. We performed grey-scale ultrasound and 2 D-SWE examinations before operation. All the nodules were divided into two groups according to the pathological result. We used statistical software to investigate different parameters between two groups. Results: Totally 170 malignant and 119 benign nodules were performed in our study. SWE measurements were significantly different between two categories. The maximum Young's modulus value was considered to be the best parameter in disgnosing thyrois nodules. On ROC curve,the area under the curve( AUC) of the maximum Young's modulus value was 0. 764. Taking 52. 7 kPa as the threshold of maximum Young's modulus value,the sensitivity was 75. 3% and specificity was 73. 1%. Conclusion: The maximum Young's modulus value can help diagnose malignant thyroid nodules with K-TIRADS 3-5 category.
Objective: To evaluate the utility of shear wave elastography( SWE) in diagnosing K-TIRADS 3-5 category thyroid nodules. Methods: A group of 289 thyroid nodules with K-RADS 3-5 category were enrolled in our research. We performed grey-scale ultrasound and 2 D-SWE examinations before operation. All the nodules were divided into two groups according to the pathological result. We used statistical software to investigate different parameters between two groups. Results: Totally 170 malignant and 119 benign nodules were performed in our study. SWE measurements were significantly different between two categories. The maximum Young's modulus value was considered to be the best parameter in disgnosing thyrois nodules. On ROC curve,the area under the curve( AUC) of the maximum Young's modulus value was 0. 764. Taking 52. 7 kPa as the threshold of maximum Young's modulus value,the sensitivity was 75. 3% and specificity was 73. 1%. Conclusion: The maximum Young's modulus value can help diagnose malignant thyroid nodules with K-TIRADS 3-5 category.
引文
[1]Moon WJ,Jung SL,Lee JH,et al.Benign and malignant thyroid nodules:US differentiation-multicenter retrospective study[J].Radiology,2008,247(3):762-770.
[2]Lyshchik A,Higashi T,Asato R,et al.Thyroid gland tumor diagnosis at US elastography[J].Radiology,2005,237(1):202-211.
[3]Lyshchik A,Higashi T,Asato R,et al.Elastic moduli of thyroid tissues under compression[J].Ultrason Imaging,2005,27(2):101-110.
[4]Hoang JK,Lee WK,Lee M,et al.US Features of thyroid malignancy:Pearls and pitfalls[J].Radiographics,2007,27(3):847-860.
[5]Liu B,Liang J,Zheng Y,et al.Two-dimensional shear wave elastograghy as promising diagnostic tool for predicting malignant thyroid nodules:A prospective single center experience[J].Eur Radiol,2015(25):624-634.
[6]Appetecchia M,Solivetti FM.The association of color flow doppler sonography and conventional ultrasonography improves the diagnosis of thyroid carcinoma[J].Horm Res,2006(66):249-256.
[7]Ozel A,Erturk SM,Ercan A,et al.The diagnostic efficiency of ultrasound in characterization for thyroid nodules:How many criteria are required to predict malignancy[J]?Med Ultrason,2012(14):24-28.
[8]Horvath E,Majlis S,Rossi R.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J].J Clin Endocrinol Metab,2009(94):1748-1751.
[9]Liang XN,Guo RJ,Li S.Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography,acoustic radiation force impulse,and contrast-enhanced ultrasonography[J].Eur Rev Med Pharmacol Sci,2014(18):3601-3610.
[10]Shao J,Shen Y,Lu J,Wang J.Ultrasound scoring in combination with ultrasound elastography for differentiating benign and malignant thyroid nodules[J].Clin Endocrinol(Oxf),2015(83):254-260.
[11]Shin JH,Beak JH.Ultrasonography diagnosis and imaging-based management of thyroid nodules:Revised Korean society of thyroid radiology consensus statement and recommendations[J].Korean JRadiol,2016,17(3):370-395.
[12]WANG Tao,WANG Xuemei,ZHANG Yixia,et al.Quantitative assessment of real-time shear wave elastography imaging in differentiation benign and malignant thyroid nodules[J].Chinese Journal of Medical Image,2012,20(9):684-687.[王涛,王学梅,张义侠,等.实时剪切波弹性成像鉴别甲状腺结节良恶性的定量分析[J].中国医学影像学杂志,2012,20(9):684-687.]
[13]Bryan R Haugen,Erik K Alexander,Keith C Bible,et al.2015 american thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):372-381.
[14]Su Min Ha,Hye Shin Ahn,Jung Hwan Beck,et al.Validation of three scoring risk-stratification models for thyroid nodules[J].Thyroid,2017(27):1550-1557.
[15]Park AY,Son EJ,Han K,et al.Shear wave elastography of thyroid nodules for the prediction of malignancy in a large-scale study[J].Eur Radiol,2015(84):407-412.
[16]WANG Dan,XU Huixiong,HE Yaping,et al.Value of shear wave elastography imaging in differentiating benign and malignant thyroid nodules[J].Chinese General Practice,2017,20(18):2279-2283.[王丹,徐辉熊,贺亚萍,等.剪切波弹性成像鉴别甲状腺良恶性结节的诊断价值[J].中国全科医学,2017,20(18):2279-2283.
[2]Lyshchik A,Higashi T,Asato R,et al.Thyroid gland tumor diagnosis at US elastography[J].Radiology,2005,237(1):202-211.
[3]Lyshchik A,Higashi T,Asato R,et al.Elastic moduli of thyroid tissues under compression[J].Ultrason Imaging,2005,27(2):101-110.
[4]Hoang JK,Lee WK,Lee M,et al.US Features of thyroid malignancy:Pearls and pitfalls[J].Radiographics,2007,27(3):847-860.
[5]Liu B,Liang J,Zheng Y,et al.Two-dimensional shear wave elastograghy as promising diagnostic tool for predicting malignant thyroid nodules:A prospective single center experience[J].Eur Radiol,2015(25):624-634.
[6]Appetecchia M,Solivetti FM.The association of color flow doppler sonography and conventional ultrasonography improves the diagnosis of thyroid carcinoma[J].Horm Res,2006(66):249-256.
[7]Ozel A,Erturk SM,Ercan A,et al.The diagnostic efficiency of ultrasound in characterization for thyroid nodules:How many criteria are required to predict malignancy[J]?Med Ultrason,2012(14):24-28.
[8]Horvath E,Majlis S,Rossi R.An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management[J].J Clin Endocrinol Metab,2009(94):1748-1751.
[9]Liang XN,Guo RJ,Li S.Binary logistic regression analysis of solid thyroid nodules imaged by high-frequency ultrasonography,acoustic radiation force impulse,and contrast-enhanced ultrasonography[J].Eur Rev Med Pharmacol Sci,2014(18):3601-3610.
[10]Shao J,Shen Y,Lu J,Wang J.Ultrasound scoring in combination with ultrasound elastography for differentiating benign and malignant thyroid nodules[J].Clin Endocrinol(Oxf),2015(83):254-260.
[11]Shin JH,Beak JH.Ultrasonography diagnosis and imaging-based management of thyroid nodules:Revised Korean society of thyroid radiology consensus statement and recommendations[J].Korean JRadiol,2016,17(3):370-395.
[12]WANG Tao,WANG Xuemei,ZHANG Yixia,et al.Quantitative assessment of real-time shear wave elastography imaging in differentiation benign and malignant thyroid nodules[J].Chinese Journal of Medical Image,2012,20(9):684-687.[王涛,王学梅,张义侠,等.实时剪切波弹性成像鉴别甲状腺结节良恶性的定量分析[J].中国医学影像学杂志,2012,20(9):684-687.]
[13]Bryan R Haugen,Erik K Alexander,Keith C Bible,et al.2015 american thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):372-381.
[14]Su Min Ha,Hye Shin Ahn,Jung Hwan Beck,et al.Validation of three scoring risk-stratification models for thyroid nodules[J].Thyroid,2017(27):1550-1557.
[15]Park AY,Son EJ,Han K,et al.Shear wave elastography of thyroid nodules for the prediction of malignancy in a large-scale study[J].Eur Radiol,2015(84):407-412.
[16]WANG Dan,XU Huixiong,HE Yaping,et al.Value of shear wave elastography imaging in differentiating benign and malignant thyroid nodules[J].Chinese General Practice,2017,20(18):2279-2283.[王丹,徐辉熊,贺亚萍,等.剪切波弹性成像鉴别甲状腺良恶性结节的诊断价值[J].中国全科医学,2017,20(18):2279-2283.