Department of Ultrasound, First People's Hospital Shanghai Jiaotong University, 85 Wujin Rd, 200080 Shanghai, China.
J Ultrasound Med. 2014 Feb;33(2):257-64. doi: 10.7863/ultra.33.2.257.
This study aimed to investigate the value of sonographic features including Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) for differentiating benign and malignant thyroid nodules smaller than 10 mm.
Seventy-one thyroid nodules smaller than 10 mm with pathologic diagnoses were included in this study. The conventional sonographic features and quantitative elasticity features (VTQ) were observed and compared between benign and malignant nodules.
There were 39 benign and 32 malignant nodules according to histopathologic examination. When compared with benign nodules, malignant nodules were more frequently taller than wide, poorly defined, and markedly hypoechoic (P < .05). Color Doppler sonographic features were not significantly different between benign and malignant nodules. The VTQ value for malignant nodules (mean ± SD 3.260 ± 0.725 m/s) was significantly higher than that of benign ones (2.108 ± 0.455 m/s; P < .001). The cutoff point for the differential diagnosis was 2.910 m/s, with sensitivity, specificity, a positive predictive value, a negative predictive value, and diagnostic accuracy of 71.9%, 100%, 100%, 81.2%, and 87.3% respectively. Logistic regression analysis showed that a taller-than-wide shape, a poorly defined boundary, marked hypoechogenicity, and a VTQ value greater than 2.910 m/s were independent risk factors for malignancy, with odds ratios of 69.366, 41.864, 5.945, and 64.991. The combination of VTQ with a taller-than-wide shape had the highest sensitivity and specificity of 90.6% and 97.4%.
The shape, margin, echogenicity, and VTQ value are useful sonographic criteria for differentiating benign and malignant thyroid nodules smaller than 10 mm. When VTQ was combined with B-mode sonographic features, the sensitivity was improved significantly.
本研究旨在探讨超声特征（包括西门子医疗解决方案公司的声触诊组织量化技术[VTQ]）在鉴别 10mm 以下良恶性甲状腺结节中的价值。
本研究纳入了 71 个直径小于 10mm 且经病理诊断的甲状腺结节。观察并比较了良恶性结节的常规超声特征和定量弹性特征（VTQ）。
根据组织病理学检查，39 个为良性结节，32 个为恶性结节。与良性结节相比，恶性结节更常见于纵横比大于 1、边界不清和显著低回声（P＜0.05）。良恶性结节的彩色多普勒超声特征无显著差异。恶性结节的 VTQ 值（均值±标准差，3.260±0.725m/s）显著高于良性结节（2.108±0.455m/s；P＜0.001）。鉴别诊断的截断值为 2.910m/s，其诊断良恶性结节的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为 71.9%、100%、100%、81.2%和 87.3%。Logistic 回归分析表明，纵横比大于 1、边界不清、显著低回声和 VTQ 值大于 2.910m/s 是恶性的独立危险因素，比值比分别为 69.366、41.864、5.945 和 64.991。VTQ 联合纵横比大于 1 的诊断效能最高，敏感度和特异度分别为 90.6%和 97.4%。
对于直径小于 10mm 的甲状腺结节，形状、边界、回声和 VTQ 值是有价值的超声鉴别标准。当 VTQ 与 B 型超声特征结合时，敏感度显著提高。
