弹性成像定量分析联合硬环征在甲状腺良恶性结节鉴别诊断中的应用价值分析

目的:探究弹性定量分析联合硬环征在甲状腺良恶性结节鉴别诊断中的应用价值。方法:回顾性分析2018年1月至2018年9月于我院行手术或穿刺活检病理证实的121例甲状腺结节患者临床资料,所有患者均行弹性成像定量分析以及剪切波弹性成像(SWE)分析,计算弹性成像定量分析、SWE分析以及联合检测,以病理检查结果为金标准(良性78个,恶性43个),对甲状腺良恶性结节诊断的敏感性、特异度、准确性、阳性预测值以及阴性预测值,分别绘制弹性成像定量分析、SWE以及联合检测的受试者工作特征(ROC)曲线,并比较ROC曲线下面积。结果:(1)弹性定量分析诊断良性结节87个,恶性34个,敏感性73.08%,特异度30.23%,阳性预测值65.51%,阴性预测值38.24%;(2)SWE分析良性结节76个,恶性结节45个,敏感性64.10%,特异度39.53%,阳性预测值65.79%,阴性预测值37.78%;(3)联合检测良性结节73个,恶性结节48个,敏感性89.74%,特异度93.02%,阳性预测值95.89%,阴性预测值83.33%;(4)联合检测敏感性、特异度、阳性预测值及阴性预测值均高于单独检测(P 0.05);(5)弹性成像定量分析、SWE及联合检测ROC曲线下面积分别为0.843、0.819、0.940,联合检测准确率高于单一检测(P0.05);SWE分析甲状腺良恶性结节的弹性模量值Emean、Emin、Emax、Esd、Emean-p及Emean-m均显著大于恶性结节(P 0.05)。结论:弹性成像定量分析联合硬环征检测能够显著提高对甲状腺结节良恶性病变的诊断敏感性及特异度,具有较高的临床应用价值。

Analysis of the Application value of Elastography Quantitative Analysis Combined with Hard Ring Sign for the Differential Diagnosis of Benign and Malignant Thyroid Nodules

ABSTRACT Objective: To explore the diagnostic value of elastic quantitative analysis combined with hard ring sign for differentiating benign and malignant thyroid nodules. Methods: The clinical data of 121 cases of patients with thyroid nodules confirmed by operation or biopsy in our hospital from January 2018 to September 2018 were retrospectively analyzed. All the patients underwent elastography quantitative analysis and shear wave elastography (SWE) analysis. Quantitative analysis of elastography, SWE analysis and combined de- tection were performed. The results were golden standard (78 benign and 43 malignant), sensitivity, specificity, accuracy, positive predic- tive value and negative predictive value for the diagnosis of benign and malignant thyroid nodules. Quantitative analysis of elastography, SWE and ROC curves were drawn respectively, and the areas under ROC curves were compared. Results: (1) Elastic quantitative analy- sis of 87 benign nodules, 34 malignant, the sensitivity was 73.08%, the specificity was 30.23%, the positive predictive value was 65.51%, the negative predictive value was 38.24%; (2) SWE analysis of 76 benign nodules, 45 malignant nodules, the sensitivity was 64.10%, the specificity was 39.53%, the positive predictive value was 65.79%, the negative predictive value was 37.78%; (3) 73 benign nodules, 48 malignant nodules, the sensitivity was 89.74%, the specificity was 93.02%, the positive predictive value was 95.89%, the negative predic- tive value was 83.33%; (4) The sensitivity, specificity, positive predictive value and negative predictive value of combined detection were higher than those of single detection (P<0.05); (5) Quantitative analysis of elastography. The area under ROC curve was 0.843, 0.819 and 0.940, respectively. The accuracy of combined detection was higher than that of single method (P<0.05). SWE analysis of the modulus of elasticity of benign and malignant thyroid nodules Emean, Emin, Emax, Esd, Emean-p and Emean-m were significantly larger than the malignant nodules(P<0.05). Conclusion: Quantitative analysis of elastography combined with hard ring sign detection can significantly improve the sensitivity and specificity in the diagnosis of benign and malignant thyroid nodules, and it has high clinical value.