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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2015, Vol. 12 ›› Issue (07) : 564 -567. doi: 10.3877/cma.j.issn.1672-6448.2015.05.014

所属专题： 文献；

浅表器官超声影像学

Q-analysis实时弹性成像技术在甲状腺结节良恶性鉴别诊断的应用价值
杨颖颖1,†(), 雷凯荣1, 吴旭初1, 龙晶晶1, 叶芳丽1, 杨雅婷1, 崔克勤2, 宋成福3   
  1. 1. 200093　上海，同济大学附属杨浦医院超声医学科
    2. 200093　上海，同济大学附属杨浦医院内分泌科
    3. 200093　上海，同济大学附属杨浦医院老年医学四科
  • 收稿日期:2015-02-06 出版日期:2015-07-01
  • 通信作者: 杨颖颖
  • 基金资助:
    上海市杨浦区卫计委科研基金项目(201303)

Value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules

Yingying Yang1,†(), Kairong Lei1, Xuchu Wu1, Jingjing Long1, Fangli Ye1, Yating Yang1, Keqin Cui2, Chengfu Song3   

  1. 1. Department of Ultrasound, Yangpu Hospital of Tongji University, Shanghai 200093, China
    2. Department of Endocrinology, Yangpu Hospital of Tongji University, Shanghai 200093, China
    3. Department of Gerontology, Yangpu Hospital of Tongji University, Shanghai 200093, China
  • Received:2015-02-06 Published:2015-07-01
  • Corresponding author: Yingying Yang
  • About author:
    Corresponding author: Yang Yingying, Email:
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引用本文：

杨颖颖, 雷凯荣, 吴旭初, 龙晶晶, 叶芳丽, 杨雅婷, 崔克勤, 宋成福. Q-analysis实时弹性成像技术在甲状腺结节良恶性鉴别诊断的应用价值[J]. 中华医学超声杂志（电子版）, 2015, 12(07): 564-567.

Yingying Yang, Kairong Lei, Xuchu Wu, Jingjing Long, Fangli Ye, Yating Yang, Keqin Cui, Chengfu Song. Value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(07): 564-567.

目的

探讨Q-analysis实时弹性技术对甲状腺结节良恶性鉴别诊断的应用价值。

方法

选取2012年2月至2014年6月在同济大学附属杨浦医院行甲状腺超声检查，并经甲状腺外科手术获得最终病理诊断甲状腺结节患者62例，共86个甲状腺结节，进行Q-analysis实时定量弹性成像，获得Q-analysis定量曲线及结节的整体弹性比值及局部弹性比值。

结果

86个病灶中恶性结节35个，良性结节51个。实时弹性图像上显示良性结节的整体及局部弹性比值Q-analysis曲线较平稳，峰值低；恶性结节曲线波动大，峰值高。恶性结节与良性结节的整体弹性比值分别为3.59±0.84、2.32±0.56，两者比较差异有统计学意义（P=0.000）；恶性结节与良性结节的局部弹性比值分别为3.96±1.32、2.39±0.58，两者比较差异有统计学意义（P=0.000）。恶性结节与良性结节的整体弹性比值与局部弹性比值的最佳分界点分别为3.25、3.45，诊断敏感度、特异度及准确性分别为71.4%、96.1%、86.0%与68.6%、96.1%、84.9%。整体及局部弹性比值的诊断效能比较，差异无统计学意义（P=0.591）。

结论

Q-analysis实时弹性成像可提供甲状腺结节的动态弹性特征。定量指标整体及局部弹性比值有助于甲状腺结节良恶性的鉴别诊断。

关键词: 甲状腺结节, 弹性成像技术, 超声检查
Objective

To investigate the value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules.

Methods

Eighty-six thyroid nodules in 62 patients with pathologic diagnosis were included in this study and were examined using Q-analysis real-time elasticity. The real-time elasticity features were observed and the quantitative index including the whole elasticity rate and the local elasticity rate were compared between benign and malignant nodules.

Results

There were 51 benign and 35 malignant nodules according to histopathological examination. The Q-analysis curve of real-time elasticity of benign nodules was smoother and with lower peak, compared with that of malignant nodules. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.59±0.84 vs 2.32±0.56, P=0.000). And the local elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.96±1.32 vs 2.39±0.58, P=0.000). The cutoff point of whole elasticity rate for the differential diagnosis was 3.25 with sensitivity, specificity and diagnostic accuracy as 71.4%, 96.1% and 86.0% respectively. The cutoff point of local elasticity rate for the differential diagnosis was 3.45 with sensitivity, specificity and diagnostic accuracy as 68.6%, 96.1% and 84.9% respectively. The diagnostic efficiency of whole elasticity rate and local elasticity rate had no significant difference (P=0.591).

Conclusions

Q-analysis real-time elasticity could provide the real-time elasticity features of thyroid nodules. The whole and local elasticity rate as the quantitative index contributed to the differential diagnosis of benign and malignant thyroid nodules.

Key words: Thyroid nodules, Elasticity imaging techniques, Ultrasonography.
图1，2 甲状腺乳头状癌的二维超声图像、弹性成像及弹性定量曲线。图1（左）为二维超声图像，示一单发、低回声结节，形态呈类圆形，图1（右）为弹性成像图，示结节呈蓝色成像，且不均匀，提示结节较硬；图2为弹性定量曲线，5 s内（4~9 s）病灶整体及局部弹性比值较高，且曲线波动较大
表1 甲状腺良恶性结节的整体及局部弹性比值（±s）
组别 个数 整体弹性比值 局部弹性比值
恶性结节 35 3.59±0.84 3.96±1.32
良性结节 51 2.32±0.56 2.39±0.58
t值 ? 8.307 6.837
P值 ? 0.000 0.000
图3 Q-analysis实时弹性技术检测甲状腺结节的整体弹性比值及局部弹性比值的ROC曲线
1
Brito JP, Yarur AJ, Prokop LJ, et al. Prevalence of thyroid cancer in multinodular goiter versus single nodule: a systematic review and meta-analysis[J]. Thyroid, 2003, 23(4): 449-455.
2
Moon WJ, Baek JH, Jung SL, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations[J]. Korean J Radiol, 2011, 12(1): 1-14.
3
Bojunga J, Herrmann E, Meyer G, et al. Realtime elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis[J]. Thyroid, 2010, 20(10): 1142-1150.
4
Tranquart F, Bleuzen A, Pierre-Renoult P, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues[J]. Ultrason Imaging, 1991, 13(2): 111-134.
5
徐智章，俞清. 超声弹性成像原理及初步应用[J]. 上海医学影像, 2005, 14(1): 3-5.
6
Tranquart F, Bleuzen A, Pierre-Renoult P, et al. Elastosonography of thyroid lesions[J]. J Radiol, 2008, 89(1): 35-39.
7
Cassinotto C, Lapuyade B, Aït-Ali A, et al. Liver fibrosis: noninvasive assessment with acoustic radiation force impulse elastography--comparison with FibroScan M and XL probes and FibroTest in patients with chronic liver disease[J]. Radiology, 2013, 269(1): 283-292.
8
Evans A, Whelehan P, Thomson K, et al. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses[J]. Breast Cancer Res, 2010, 12(6): R104.
9
Zhang HP, Shi QS, Gu JY, et al. Combined value of Virtual Touch tissue quantification and conventional sonographic features for differentiating benign and malignant thyroid nodules smaller than 10 mm[J]. J Ultrasound Med, 2014, 33(2): 257-264.
10
Zhang YF, Xu HX, He Y, et al. Virtual touch tissue quantification of acoustic radiation force impulse: a new ultrasound elastic imaging in the diagnosis of thyroid nodules[J]. Plos One, 2012, 7(11): e49094.
11
张彧，刘春波，付瑶 等. Q-analysis实时组织弹性定量分析在乳腺肿物良恶性鉴别中的应用[J/CD]. 中华医学超声杂志:电子版, 2013, 10(6): 494-499.
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