Hu Lei, He Nian An, Xie Li, Ye Xianjun, Liu Xiao, Pei Chong, Zhou Hang Cheng, Zhong Wen
Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Department of Respiratory and Critical Care Medicine, The First People's Hospital of Hefei City, Third Affiliated Hospital of Anhui Medical University, Hefei, China.
J Ultrasound Med. 2020 Nov;39(11):2183-2193. doi: 10.1002/jum.15329. Epub 2020 May 15.
To evaluate the surrounding tissue stiffness measured by sound touch elastography for differential diagnosis of thyroid nodules (TNs).
Thirty-nine benign and 90 malignant TNs were included in this study. The conventional ultrasound features, the maximum Young modulus value of the stiffness of the TNs (recorded as E), and the stiffness of the 0.5-, 1.0-, 1.5-, and 2.0-mm perinodular regions of the TNs (recorded as E , E , E , and E , respectively) were prospectively analyzed and compared to histopathologic results. The abundance of collagen fibers at various widths in the perinodular regions of the TNs was evaluated by Masson staining and ImageJ software (National Institutes of Health, Bethesda, MD). The fibrous structures in the perinodular regions of the TNs were classified.
The various E values of malignant TNs were significantly higher than those of benign TNs (P < .001 for all). E correlated highly with E in the malignant TNs and in all samples (r = 0.722 and 0.772; P < .001 for both). yielded the highest area under the receiving operating characteristic curve value (0.96) for the differential diagnosis of TNs. The abundance of collagen fibers in the 2-mm perinodular region of the TNs was closely correlated with E in the malignant TNs and in all samples (r =0.729 and 0.867; P < .001). The E values for different levels of disorder of the tissue surrounding TNs were significantly different (P < .01 for all).
Perinodular stiffness measured by sound touch elastography improved the diagnostic accuracy in TNs.
评估通过声触诊弹性成像测量的周围组织硬度对甲状腺结节（TNs）进行鉴别诊断的价值。
本研究纳入了39个良性TNs和90个恶性TNs。前瞻性分析并比较了TNs的常规超声特征、TNs硬度的最大杨氏模量值（记录为E）以及TNs周围0.5、1.0、1.5和2.0 mm区域的硬度（分别记录为E 、E 、E 和E ）与组织病理学结果。通过Masson染色和ImageJ软件（美国国立卫生研究院，马里兰州贝塞斯达）评估TNs周围区域不同宽度的胶原纤维丰度。对TNs周围区域的纤维结构进行分类。
恶性TNs的各种E值显著高于良性TNs（所有P均<0.001）。在恶性TNs和所有样本中，E与E高度相关（r分别为0.722和0.772；两者P均<0.001）。 在TNs鉴别诊断的受试者工作特征曲线下面积值最高（0.96）。TNs 2 mm周围区域的胶原纤维丰度与恶性TNs和所有样本中的E密切相关（r分别为0.729和0.867；P均<0.001）。TNs周围组织不同紊乱程度的E值有显著差异（所有P均<0.01）。
通过声触诊弹性成像测量的结节周围硬度提高了TNs的诊断准确性。
