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超声剪切波弹性成像与超声造影在甲状腺良恶性病变患者鉴别诊断中的应用

Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions.

作者信息

Xu Jing, Wang Ping, Yue Wensheng, Luo Yuqun, Li Zukun

机构信息

Department of Radiology, East Branch Hospital of Sichuan Provincial People's Hospital, Chengdu, China.

Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

出版信息

Gland Surg. 2020 Dec;9(6):2136-2143. doi: 10.21037/gs-20-819.

Abstract

BACKGROUND

Thyroid nodules are a common thyroid disorder. The aim of the present study was to observe the application value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of patients with benign and malignant thyroid lesions.

METHODS

Eighty-two patients with thyroid nodules (96 thyroid nodules) at our hospital were enrolled. All patients underwent ultrasonic SWE and CEUS examination. With surgical pathology as the gold standard, the Young's modulus, CEUS imaging features, and quantitative parameters were compared between the benign and malignant groups. The diagnostic efficiency of SWE, CEUS, and their combination was analyzed by receiver-operating characteristic curve (ROC).

RESULTS

The average of the Young's modulus in the malignant group was significantly higher than that of the benign group (P<0.05). There were significant differences in the CEUS images of nodules between the benign and malignant groups in terms of boundary conditions, morphology, perfusion intensity, homogeneous enhancement, and perfusion defects (P<0.05), while there were no significant difference in initial increase time, peak intensity, time to peak, and area under the curve (P>0.05). The curve sharpness in the benign group was significantly lower than that of the malignant group (P<0.05). ROC analysis found that the diagnostic sensitivity and specificity of SWE, CEUS, and their combination were 90.1% and 81.6%, 67.8% and 75.4%, and 97.3% and 71.5%, respectively.

CONCLUSIONS

Compared with CEUS, the sensitivity and specificity of SWE were relatively higher in the differential diagnosis of benign and malignant thyroid lesions, and a combination of both can improve the diagnostic sensitivity of SWE alone to a certain extent.

摘要

背景

甲状腺结节是一种常见的甲状腺疾病。本研究的目的是观察超声剪切波弹性成像(SWE)和超声造影(CEUS)在甲状腺良恶性病变患者鉴别诊断中的应用价值。

方法

选取我院82例甲状腺结节患者(共96个甲状腺结节)。所有患者均接受超声SWE和CEUS检查。以手术病理为金标准,比较良恶性组之间的杨氏模量、CEUS成像特征及定量参数。通过受试者操作特征曲线(ROC)分析SWE、CEUS及其联合应用的诊断效能。

结果

恶性组的杨氏模量平均值显著高于良性组(P<0.05)。良恶性组结节的CEUS图像在边界情况、形态、灌注强度、均匀增强及灌注缺损方面存在显著差异(P<0.05),而在开始增强时间、峰值强度、达峰时间及曲线下面积方面无显著差异(P>0.05)。良性组的曲线锐利度显著低于恶性组(P<0.05)。ROC分析发现,SWE、CEUS及其联合应用的诊断敏感性和特异性分别为90.1%和81.6%、67.8%和75.4%、97.3%和71.5%。

结论

在甲状腺良恶性病变的鉴别诊断中,与CEUS相比,SWE的敏感性和特异性相对较高,两者联合应用可在一定程度上提高单独使用SWE的诊断敏感性。

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