常规超声联合超声弹性成像对甲状腺微小乳头状癌诊断价值的Meta分析
|
摘要
目的:通过Meta分析评价常规超声联合超声弹性成像对甲状腺微小乳头状癌(PTMC)的诊断价值。方法:计算机检索多个国内外数据库中常规超声联合超声弹性成像诊断PTMC相关的中英文文献,检索时限为2013年1月—2018年8月,根据预先设定的纳入和排除标准,由2名研究人员严格筛选文献、提取数据后,采用QUADAS-2工具评估纳入文献的偏倚风险,使用Stata12.0软件和MetaDisc1.4进行Meta分析。结果:共纳入16篇文献,共包含2826个病灶。因纳入研究有明显的异质性,故采用随机效应模型做相应的Meta分析。所得结果表明,这种联合检测方法检测甲状腺微小癌的合并敏感度、特异度、阳性似然比、阴性似然比和诊断优势比分别为0.91(95%CI=0.89～0.92)、0.90(95%CI=0.89～0.92)、8.94(95%CI=5.45～14.65)、0.09(95%CI=0.05～0.16)和103.05(95%CI=52.06～203.98),SROC曲线下面积AUC为0.9657(Q指数为0.9130)。Deek漏斗图示无明显发表偏倚(P=0.485)。结论:常规超声联合超声弹性成像诊断PTMC具备较高的诊断效能,为PTMC的诊断提供了一种可行的方法。
Objective: To evaluate the diagnostic value of routine ultrasonography combined with elastosonography in diagnosing papillary thyroid microcarcinoma(PTMC). Methods: The studies concerning routine ultrasonography combined with elastosonography for diagnosis of PTMC both in Chinese and in English were searched in several national and international online databases. Search period was set from 2013 to August 2018. After strict screening and data extraction by two reviewers according to the predefined inclusion and exclusion criteria, the risk of bias of the included studies was assessed by QUADAS-2 tool, and Meta-analysis was performed using STATA12.0 and Meta-Disc 1.4 software.Results: Sixteen studies were finally included involving 2 826 lesions. Random effects model was used for Metaanalysis due to the substantial heterogeneity of the included studies. The obtained results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for diagnosis of PTMC were 0.91(95% CI=0.89–0.92), 0.90(95% CI=0.89–0.92), 8.94(95% CI=5.45–14.65), 0.09(95% CI= 0.05–0.16) and 103.05(95% CI=52.06–203.98) respectively, and the area under the SROC curve was 0.9657(the Q index was 0.9130). The Deek's plot showed no significant publication bias(P=0.485).Conclusion: Routine ultrasonography combined with elastosonography has a relatively high diagnostic efficiency for detecting PTMC, which provides a feasible method for diagnosis of PTMC.
Objective: To evaluate the diagnostic value of routine ultrasonography combined with elastosonography in diagnosing papillary thyroid microcarcinoma(PTMC). Methods: The studies concerning routine ultrasonography combined with elastosonography for diagnosis of PTMC both in Chinese and in English were searched in several national and international online databases. Search period was set from 2013 to August 2018. After strict screening and data extraction by two reviewers according to the predefined inclusion and exclusion criteria, the risk of bias of the included studies was assessed by QUADAS-2 tool, and Meta-analysis was performed using STATA12.0 and Meta-Disc 1.4 software.Results: Sixteen studies were finally included involving 2 826 lesions. Random effects model was used for Metaanalysis due to the substantial heterogeneity of the included studies. The obtained results showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for diagnosis of PTMC were 0.91(95% CI=0.89–0.92), 0.90(95% CI=0.89–0.92), 8.94(95% CI=5.45–14.65), 0.09(95% CI= 0.05–0.16) and 103.05(95% CI=52.06–203.98) respectively, and the area under the SROC curve was 0.9657(the Q index was 0.9130). The Deek's plot showed no significant publication bias(P=0.485).Conclusion: Routine ultrasonography combined with elastosonography has a relatively high diagnostic efficiency for detecting PTMC, which provides a feasible method for diagnosis of PTMC.
引文
[1]Delellis RA,Lloyd RV,Heitz PU,et al.World Health Organization Classification of Tumors:Pathology&Genetics[M].Lyon:IARC,2004.
[2]Yilmaz AF,Saydam G,Sahin F,et al.Granulocytic sarcoma:a systematic review[J].Am J Blood Res,2013,3(4):265-270.
[3]Liu PI,Ishimaru T,McGregor DH,et al.Autopsy study of granulocytic sarcoma(chloroma)in patients with myelogenous leukemia,Hiroshima-Nagasaki 1949-1969[J].Cancer,1973,31(4):948-955.
[4]Wang H,Zhao L,Xin X,et al.Diagnostic value of elastosonography for thyroid microcarcinoma[J].Ultrasonics,2014,54(7):1945-1949.doi:10.1016/j.ultras.2014.04.027.
[5]Whiting PF,Rutjes AW,Westwood ME,et al.QUADAS-2:a revised tool for the quality assessment of diagnostic accuracy studies[J].Ann Intern Med,2011,155(8):529-536.doi:10.7326/0003-4819-155-8-201110180-00009.
[6]黄宇虹,陈伟军,梁启硕,等.常规超声联合超声弹性成像对甲状腺微小癌的诊断价值[J].中国医药导报,2016,13(19):112-115.Huang YH,Chen WJ,Liang QS,et al.Diagnostic value of conventional ultrasound combined with elastography in thyroid microcarcinoma[J].China Medical Herald,2016,13(19):112-115.
[7]李晨,高光旭,李建宁,等.常规超声联合弹性成像诊断甲状腺微小癌的价值[J].中国医学影像学杂志,2016,24(11):805-809.doi:10.3969/j.issn.1005-5185.2016.11.002.Li C,Gao GX,Li JN,et al.Conventional Ultrasound Combined with Elastography in Diagnosis of Thyroid Microcarcinoma[J].Chinese Journal of Medical Imaging,2016,24(11):805-809.doi:10.3969/j.issn.1005-5185.2016.11.002.
[8]宋琳琳,詹维伟.超声甲状腺影像报告与数据系统及超声弹性成像对甲状腺微小癌的诊断价值[J].中华医学超声杂志:电子版,2014,11(12):49-52.doi:10.3877/cma.j.issn.1672-6448.2014.12.012.Song LL,Zhan WW.Value of thyroid imaging reporting and data system and ultrasound elastography for diagnosing thyroid microcarcinoma[J].Chinese Journal of Medical Ultrasound:Electronic Edition,2014,11(12):49-52.doi:10.3877/cma.j.issn.1672-6448.2014.12.012.
[9]高芙蓉,李婵娟,张福刚,等.超声与弹性成像联合在甲状腺微小乳头状癌中的应用价值[J].现代实用医学,2016,28(5):578-580.doi:10.3969/j.issn.1671-0800.2016.05.009.Gao F R,Li C J,Zhang F G,et al.Application value of ultrasonography combined with elastosonography for thyroid microcarcinoma[J].Modern Practical Medicine,2016,28(5):578-580.doi:10.3969/j.issn.1671-0800.2016.05.009.
[10]何辉,郭聪,储朝莉.体检中彩色超声联合弹性成像对甲状腺微小癌的诊断价值[J].解放军预防医学杂志,2017,35(9):1142-1143.He H,Guo C,Chu ZL.Diagnostic value of combined color ultrasound and elastosonography in diagnosis of thyroid microcarcinoma[J].Journal of Preventive Medicine of Chinese People's Liberation Army,2017,35(9):1142-1143.
[11]郑幸丽.二维超声、彩色多普勒联合弹性成像对甲状腺微小癌50例诊断体会[J].河南医学高等专科学校学报,2016,28(3):203-204.Zheng XL.Experience of 50 cases of thyroid microcarcinoma diagnosed by two-dimensional ultrasonography,color Doppler plus elastography[J].Journal of Henan Medical College for Staff and Workers,2016,28(3):203-204.
[12]刘海珍,程澍洁,陈宏伟,等.常规超声联合弹性成像在甲状腺微小结节良恶性病变中的诊断价值[J].中国临床研究,2017,30(11):1552-1554.doi:10.13429/j.cnki.cjcr.2017.11.032.Liu HZ,Cheng SJ,Chen HW.Diagnostic value of routine ultrasonography combined with elastosonography for identification of nature of small thyroid nodules[J].Chinese Journal of Clinical Research,2017,30(11):1552-1554.doi:10.13429/j.cnki.cjcr.2017.11.032.
[13]纪伟勉.常规超声联合超声弹性成像诊断甲状腺微小癌的效果分析[J].中国医学工程,2018,26(4):87-89.doi:10.19338/j.issn.1672-2018.04.028.Ji WM.Efficacy analysis of routine ultrasonography combined with elastosonography in diagnosis of thyroid microcarcinoma[J].China Medical Engineering,2018,26(4):87-89.doi:10.19338/j.issn.1672-2018.04.028.
[14]李圈良,唐静.超声弹性成像联合常规超声鉴别甲状腺微小结节良恶性价值分析[J].临床医学,2018,38(3):85-86.doi:10.19528/j.issn.1003-3548.2018.03.034.Li QL,Tang J.Analysis of value of elastosonography combined with routine ultrasonography for identification of the nature of small thyroid nodules[J].Clinical Medicine,2018,38(3):85-86.doi:10.19528/j.issn.1003-3548.2018.03.034.
[15]杨蕴慧.超声联合弹性成像诊断甲状腺微小乳头状癌的临床价值研究[J].现代仪器与医疗,2017,23(4):10-11.doi:10.11876/mimt201704005.Yang W H.Clinical value of ultrasonography combined with elastosonography in diagnosis of papillary thyroid microcarcinoma[J].Modern Instruments&Mediccal Treatment,2017,23(4):10-11.doi:10.11876/mimt201704005.
[16]谭宏梅,陈宁.二维超声联合超声弹性成像(UE)检查对甲状腺微小癌(TMC)的诊断效能评价[J].影像研究与医学应用,2018,2(19):237-239.doi:10.3969/j.issn.2096-3807.2018.19.164.Tan HM,Chen N.Assessment of diagnostic efficiency of twodimensional ultrasonography combined with ultrasonic elastography(UE)for thyroid microcarcinoma[J].Journal of Imaging Research and Medical Applications,2018,2(19):237-239.doi:10.3969/j.issn.2096-3807.2018.19.164.
[17]范亚娟,褚雯,张社芳.二维超声联合实时超声弹性成像检查在甲状腺微小癌诊断中的价值探讨[J].航空航天医学杂志,2017,28(3):310-312.Fan YJ,Chu W,Zhang SF.Diagnostic value of two-dimensional ultrasonography combined with real-time ultrasound elastography for thyroid microcarcinoma[J].Aerospace Medicine,2017,28(3):310-312.
[18]武元元,王军,管玲,等.TI-RADS分级联合超声弹性成像诊断甲状腺微小乳头状癌价值研究[J].中国实用外科杂志,2016,36(5):552-555.Wu YY,Wang J,Guan L.Value of combining TI-RADSand ultrasonic elastography in diagnosing papillary thyroid microcarcinoma[J].Chinese Journal of Practical Surgery,2016,36(5):552-555.
[19]芦雪娇,张艳华,刘莹,等.TI-RADS分级联合剪切波弹性成像对甲状腺微小癌的诊断价值[J].临床耳鼻咽喉头颈外科杂志2016,30(2):118-122.doi:10.13201/j.issn.1001-1781.2016.02.008.Lu XJ,Zhang YH,Liu Y,et al.Value of thyroid imaging reporting and data system and shear wave elastography for diagnosis of thyroid microcarcinoma[J].Journal of Clinical Otorhinolaryngology,2016,30(2):118-122.doi:10.13201/j.issn.1001-1781.2016.02.008.
[20]Zhang YF,Liu C,Xu HX,et al.Acoustic radiation force impulse imaging:a new tool for the diagnosis of papillary thyroid microcarcinoma[J].Biomed Res Int,2014,2014:416969.doi:10.1155/2014/416969.
[21]Li F,Zhang J,Wang Y,et al.Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma[J].Oncol Lett,2015,10(3):1371-1377.doi:10.3892/ol.2015.3387.
[22]于萍,张万蕾,于蕾,等.超声弹性成像在甲状腺微小病变诊断中的价值[J].中国超声医学杂志,2014,30(7):584-587.Yu P,Zhang WL,Yu L,et al.Value of Ultrasound Elastography in the Diagnosis of Micro-lesions[J].Chinese Journal of Ultrasound in Medicine,2014,30(7):584-587.
[23]Zheng W,Wang X,Rui Z,et al.Clinical features and therapeutic outcomes of patients with papillary thyroid microcarcinomas and larger tumors[J].Nucl Med Commun,2019,40(5):477-483.doi:10.1097/MNM.0000000000000991.
[24]胡如英,莫文魁,杨晓霞,等.甲状腺结节的前后径与横径比值对其良恶性诊断价值的Meta分析[J].中国普通外科杂志,2017,26(11):1397-1404.doi:10.3978/j.issn.1005-6947.2017.11.005.Hu RY,Mo WK,Yang XX,et al.Value of anteroposterior to transverse diameter ratio of the thyroid nodule in diagnosis of its benign and malignant nature:a Meta-analysis[J].Chinese Journal of General Surgery,2017,26(11):1397-1404.doi:10.3978/j.issn.1005-6947.2017.11.005.
[25]Shu zhen C.Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules[J].Eur J Radiol,2012,81(8):1806-1811.doi:10.1016/j.ejrad.2011.02.070.
[26]张晓光,张雨,张小利,等.超声弹性成像对乳腺癌腋窝淋巴结转移诊断价值的系统评价[J].中国循证医学杂志,2017,17(8):915-920.doi:10.7507/1672-2531.201610074.Zhang XG,Zhang Y,Zhang XL,et al.Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer:a systematic review[J].Chinese Journal of Evidence-based Medicine,2017,17(8):915-920.doi:10.7507/1672-2531.201610074.
[27]Menzilcioglu MS,Duymus M,Gungor G,et al.The value of realtime ultrasound elastography in chronic autoimmune thyroiditis.[J].Br J Radiol,2014,87(1044):20140604.doi:10.1259/bjr.20140604.
[28]Huang X,Guo L H,Xu H X,et al.Acoustic radiation force impulse induced strain elastography and point shear wave elastography for evaluation of thyroid nodules[J].Int J Clin Exp Med,2015,8(7):10956-10963.
[29]Khaled W,Reichling S,Bruhns OT,et al.Ultrasonic strain imaging and reconstructive elastography for biological tissue[J].Ultrasonics,2006,44(Suppl 1):e199-202.doi:10.1016/j.ultras.2006.06.007.
[30]何巧,李芳,孙辉.甲状腺超声影像报告与数据系统的应用和研究进展[J].中国普通外科杂志,2018,27(11):1477-1482.doi:10.7659/j.issn.1005-6947.2018.11.017.He Q,Li F,Sun H.Application of thyroid imaging reporting and data system and its research progress[J].Chinese Journal of General Surgery,2018,27(11):1477-1482.doi:10.7659/j.issn.1005-6947.2018.11.017.
[2]Yilmaz AF,Saydam G,Sahin F,et al.Granulocytic sarcoma:a systematic review[J].Am J Blood Res,2013,3(4):265-270.
[3]Liu PI,Ishimaru T,McGregor DH,et al.Autopsy study of granulocytic sarcoma(chloroma)in patients with myelogenous leukemia,Hiroshima-Nagasaki 1949-1969[J].Cancer,1973,31(4):948-955.
[4]Wang H,Zhao L,Xin X,et al.Diagnostic value of elastosonography for thyroid microcarcinoma[J].Ultrasonics,2014,54(7):1945-1949.doi:10.1016/j.ultras.2014.04.027.
[5]Whiting PF,Rutjes AW,Westwood ME,et al.QUADAS-2:a revised tool for the quality assessment of diagnostic accuracy studies[J].Ann Intern Med,2011,155(8):529-536.doi:10.7326/0003-4819-155-8-201110180-00009.
[6]黄宇虹,陈伟军,梁启硕,等.常规超声联合超声弹性成像对甲状腺微小癌的诊断价值[J].中国医药导报,2016,13(19):112-115.Huang YH,Chen WJ,Liang QS,et al.Diagnostic value of conventional ultrasound combined with elastography in thyroid microcarcinoma[J].China Medical Herald,2016,13(19):112-115.
[7]李晨,高光旭,李建宁,等.常规超声联合弹性成像诊断甲状腺微小癌的价值[J].中国医学影像学杂志,2016,24(11):805-809.doi:10.3969/j.issn.1005-5185.2016.11.002.Li C,Gao GX,Li JN,et al.Conventional Ultrasound Combined with Elastography in Diagnosis of Thyroid Microcarcinoma[J].Chinese Journal of Medical Imaging,2016,24(11):805-809.doi:10.3969/j.issn.1005-5185.2016.11.002.
[8]宋琳琳,詹维伟.超声甲状腺影像报告与数据系统及超声弹性成像对甲状腺微小癌的诊断价值[J].中华医学超声杂志:电子版,2014,11(12):49-52.doi:10.3877/cma.j.issn.1672-6448.2014.12.012.Song LL,Zhan WW.Value of thyroid imaging reporting and data system and ultrasound elastography for diagnosing thyroid microcarcinoma[J].Chinese Journal of Medical Ultrasound:Electronic Edition,2014,11(12):49-52.doi:10.3877/cma.j.issn.1672-6448.2014.12.012.
[9]高芙蓉,李婵娟,张福刚,等.超声与弹性成像联合在甲状腺微小乳头状癌中的应用价值[J].现代实用医学,2016,28(5):578-580.doi:10.3969/j.issn.1671-0800.2016.05.009.Gao F R,Li C J,Zhang F G,et al.Application value of ultrasonography combined with elastosonography for thyroid microcarcinoma[J].Modern Practical Medicine,2016,28(5):578-580.doi:10.3969/j.issn.1671-0800.2016.05.009.
[10]何辉,郭聪,储朝莉.体检中彩色超声联合弹性成像对甲状腺微小癌的诊断价值[J].解放军预防医学杂志,2017,35(9):1142-1143.He H,Guo C,Chu ZL.Diagnostic value of combined color ultrasound and elastosonography in diagnosis of thyroid microcarcinoma[J].Journal of Preventive Medicine of Chinese People's Liberation Army,2017,35(9):1142-1143.
[11]郑幸丽.二维超声、彩色多普勒联合弹性成像对甲状腺微小癌50例诊断体会[J].河南医学高等专科学校学报,2016,28(3):203-204.Zheng XL.Experience of 50 cases of thyroid microcarcinoma diagnosed by two-dimensional ultrasonography,color Doppler plus elastography[J].Journal of Henan Medical College for Staff and Workers,2016,28(3):203-204.
[12]刘海珍,程澍洁,陈宏伟,等.常规超声联合弹性成像在甲状腺微小结节良恶性病变中的诊断价值[J].中国临床研究,2017,30(11):1552-1554.doi:10.13429/j.cnki.cjcr.2017.11.032.Liu HZ,Cheng SJ,Chen HW.Diagnostic value of routine ultrasonography combined with elastosonography for identification of nature of small thyroid nodules[J].Chinese Journal of Clinical Research,2017,30(11):1552-1554.doi:10.13429/j.cnki.cjcr.2017.11.032.
[13]纪伟勉.常规超声联合超声弹性成像诊断甲状腺微小癌的效果分析[J].中国医学工程,2018,26(4):87-89.doi:10.19338/j.issn.1672-2018.04.028.Ji WM.Efficacy analysis of routine ultrasonography combined with elastosonography in diagnosis of thyroid microcarcinoma[J].China Medical Engineering,2018,26(4):87-89.doi:10.19338/j.issn.1672-2018.04.028.
[14]李圈良,唐静.超声弹性成像联合常规超声鉴别甲状腺微小结节良恶性价值分析[J].临床医学,2018,38(3):85-86.doi:10.19528/j.issn.1003-3548.2018.03.034.Li QL,Tang J.Analysis of value of elastosonography combined with routine ultrasonography for identification of the nature of small thyroid nodules[J].Clinical Medicine,2018,38(3):85-86.doi:10.19528/j.issn.1003-3548.2018.03.034.
[15]杨蕴慧.超声联合弹性成像诊断甲状腺微小乳头状癌的临床价值研究[J].现代仪器与医疗,2017,23(4):10-11.doi:10.11876/mimt201704005.Yang W H.Clinical value of ultrasonography combined with elastosonography in diagnosis of papillary thyroid microcarcinoma[J].Modern Instruments&Mediccal Treatment,2017,23(4):10-11.doi:10.11876/mimt201704005.
[16]谭宏梅,陈宁.二维超声联合超声弹性成像(UE)检查对甲状腺微小癌(TMC)的诊断效能评价[J].影像研究与医学应用,2018,2(19):237-239.doi:10.3969/j.issn.2096-3807.2018.19.164.Tan HM,Chen N.Assessment of diagnostic efficiency of twodimensional ultrasonography combined with ultrasonic elastography(UE)for thyroid microcarcinoma[J].Journal of Imaging Research and Medical Applications,2018,2(19):237-239.doi:10.3969/j.issn.2096-3807.2018.19.164.
[17]范亚娟,褚雯,张社芳.二维超声联合实时超声弹性成像检查在甲状腺微小癌诊断中的价值探讨[J].航空航天医学杂志,2017,28(3):310-312.Fan YJ,Chu W,Zhang SF.Diagnostic value of two-dimensional ultrasonography combined with real-time ultrasound elastography for thyroid microcarcinoma[J].Aerospace Medicine,2017,28(3):310-312.
[18]武元元,王军,管玲,等.TI-RADS分级联合超声弹性成像诊断甲状腺微小乳头状癌价值研究[J].中国实用外科杂志,2016,36(5):552-555.Wu YY,Wang J,Guan L.Value of combining TI-RADSand ultrasonic elastography in diagnosing papillary thyroid microcarcinoma[J].Chinese Journal of Practical Surgery,2016,36(5):552-555.
[19]芦雪娇,张艳华,刘莹,等.TI-RADS分级联合剪切波弹性成像对甲状腺微小癌的诊断价值[J].临床耳鼻咽喉头颈外科杂志2016,30(2):118-122.doi:10.13201/j.issn.1001-1781.2016.02.008.Lu XJ,Zhang YH,Liu Y,et al.Value of thyroid imaging reporting and data system and shear wave elastography for diagnosis of thyroid microcarcinoma[J].Journal of Clinical Otorhinolaryngology,2016,30(2):118-122.doi:10.13201/j.issn.1001-1781.2016.02.008.
[20]Zhang YF,Liu C,Xu HX,et al.Acoustic radiation force impulse imaging:a new tool for the diagnosis of papillary thyroid microcarcinoma[J].Biomed Res Int,2014,2014:416969.doi:10.1155/2014/416969.
[21]Li F,Zhang J,Wang Y,et al.Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma[J].Oncol Lett,2015,10(3):1371-1377.doi:10.3892/ol.2015.3387.
[22]于萍,张万蕾,于蕾,等.超声弹性成像在甲状腺微小病变诊断中的价值[J].中国超声医学杂志,2014,30(7):584-587.Yu P,Zhang WL,Yu L,et al.Value of Ultrasound Elastography in the Diagnosis of Micro-lesions[J].Chinese Journal of Ultrasound in Medicine,2014,30(7):584-587.
[23]Zheng W,Wang X,Rui Z,et al.Clinical features and therapeutic outcomes of patients with papillary thyroid microcarcinomas and larger tumors[J].Nucl Med Commun,2019,40(5):477-483.doi:10.1097/MNM.0000000000000991.
[24]胡如英,莫文魁,杨晓霞,等.甲状腺结节的前后径与横径比值对其良恶性诊断价值的Meta分析[J].中国普通外科杂志,2017,26(11):1397-1404.doi:10.3978/j.issn.1005-6947.2017.11.005.Hu RY,Mo WK,Yang XX,et al.Value of anteroposterior to transverse diameter ratio of the thyroid nodule in diagnosis of its benign and malignant nature:a Meta-analysis[J].Chinese Journal of General Surgery,2017,26(11):1397-1404.doi:10.3978/j.issn.1005-6947.2017.11.005.
[25]Shu zhen C.Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules[J].Eur J Radiol,2012,81(8):1806-1811.doi:10.1016/j.ejrad.2011.02.070.
[26]张晓光,张雨,张小利,等.超声弹性成像对乳腺癌腋窝淋巴结转移诊断价值的系统评价[J].中国循证医学杂志,2017,17(8):915-920.doi:10.7507/1672-2531.201610074.Zhang XG,Zhang Y,Zhang XL,et al.Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer:a systematic review[J].Chinese Journal of Evidence-based Medicine,2017,17(8):915-920.doi:10.7507/1672-2531.201610074.
[27]Menzilcioglu MS,Duymus M,Gungor G,et al.The value of realtime ultrasound elastography in chronic autoimmune thyroiditis.[J].Br J Radiol,2014,87(1044):20140604.doi:10.1259/bjr.20140604.
[28]Huang X,Guo L H,Xu H X,et al.Acoustic radiation force impulse induced strain elastography and point shear wave elastography for evaluation of thyroid nodules[J].Int J Clin Exp Med,2015,8(7):10956-10963.
[29]Khaled W,Reichling S,Bruhns OT,et al.Ultrasonic strain imaging and reconstructive elastography for biological tissue[J].Ultrasonics,2006,44(Suppl 1):e199-202.doi:10.1016/j.ultras.2006.06.007.
[30]何巧,李芳,孙辉.甲状腺超声影像报告与数据系统的应用和研究进展[J].中国普通外科杂志,2018,27(11):1477-1482.doi:10.7659/j.issn.1005-6947.2018.11.017.He Q,Li F,Sun H.Application of thyroid imaging reporting and data system and its research progress[J].Chinese Journal of General Surgery,2018,27(11):1477-1482.doi:10.7659/j.issn.1005-6947.2018.11.017.