剪切波弹性成像与实时弹性成像在评估甲状腺结节中的应用：一项初步研究。
Shear wave elastography versus real-time elastography on evaluation thyroid nodules: a preliminary study.
作者信息
Liu Bao-Xian, Xie Xiao-Yan, Liang Jin-Yu, Zheng Yan-Ling, Huang Guang-Liang, Zhou Lu-Yao, Wang Zhu, Xu Ming, Lu Ming-De
机构信息
Department of Medical Ultrasonics, the First Affiliated Hospital of Sun Yat-sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhong Shan Road 2, Guangzhou 510080, China.
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhong Shan Road 2, Guangzhou 510080, China.
出版信息
Eur J Radiol. 2014 Jul;83(7):1135-1143. doi: 10.1016/j.ejrad.2014.02.024. Epub 2014 Mar 4.
OBJECTIVE
To comparatively evaluate shear wave elastography (SWE) and real-time elastography (RTE) in distinguishing malignant from benign thyroid nodules.
METHODS
49 patients with 64 focal thyroid nodules were enrolled and underwent SWE and RTE before surgery. SWE elasticity indices (mean, minimum and maximum value of 2-mm region of interest) of nodules were measured. For RTE, elastograms were assessed by Rago criteria and nodules with scores of 4 or 5 were classified as suspicious for malignancy. Surgery histopathologic results were adopted as diagnostic standard.
RESULTS
Of the 64 nodules, 19 were papillary thyroid carcinomas and 45 were benign. SWE indices were significantly higher in malignant than benign nodules (P<0.05). Areas under the ROC curves (AUC) of SWE parameters were 0.840, 0.831 and 0.788, which were not significantly different from that of RTE showed as 0.880 (P=0.148-0.482). When the most accurate cut-off, 38.3kPa for mean value was applied to predict malignancy, the diagnostic specificity, sensitivity, accuracy, positive predictive value and negative predictive value of SWE and RTE were 68.4% versus 79.0%, 86.7% versus 84.4%, 81.3% versus 78.1%, 68.4% versus 64.7% and 86.7% versus 83.3%, respectively (P=0.683-1.000).
CONCLUSION
SWE as a promising tool can be performed in differentiating thyroid nodules with comparable results to RTE.
目的
比较评估剪切波弹性成像（SWE）和实时弹性成像（RTE）在鉴别甲状腺良恶性结节中的应用。
方法
纳入49例患有64个甲状腺局灶性结节的患者，术前接受SWE和RTE检查。测量结节的SWE弹性指数（感兴趣区2毫米区域的平均值、最小值和最大值）。对于RTE，根据拉戈标准评估弹性图，评分为4或5分的结节被分类为恶性可疑。采用手术组织病理学结果作为诊断标准。
结果
64个结节中，19个为甲状腺乳头状癌，45个为良性。恶性结节的SWE指数显著高于良性结节（P<0.05）。SWE参数的ROC曲线下面积（AUC）分别为0.840、0.831和0.788，与RTE的0.880相比无显著差异（P=0.148-0.482）。当采用最准确的截断值，即平均值38.3kPa来预测恶性时，SWE和RTE的诊断特异性、敏感性、准确性、阳性预测值和阴性预测值分别为68.4%对79.0%、86.7%对84.4%、81.3%对78.1%、68.4%对64.7%和86.7%对83.3%（P=0.683-1.000）。
结论
SWE作为一种有前景的工具，在鉴别甲状腺结节方面与RTE效果相当。
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