中国医科大学学报2024，Vol.53Issue(6)：541-546,6.DOI:10.12007/j.issn.0258-4646.2024.06.010
SWE联合SMI在甲状腺良恶性结节鉴别诊断中的应用
Application of SWE combined with SMI in differential diagnosis of benign versus malignant thyroid nodules
摘要
Abstract
Objective To investigate the accuracy and feasibility of shear wave elastography(SWE)combined with superb microvascular imaging(SMI)for the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 190 patients with thyroid nodu-les detected in the Ultrasound Department of our hospital from January 2021 to December 2022 who underwent ultrasound-guided fine-needle aspiration biopsy or exhibited postoperative histopathological improvement were selected as the study subjects.Among them,a total of 224 thyroid nodules(74 benign and 150 malignant nodules)were detected,all of whom underwent thyroid ultrasonography,SWE,and SMI.The parameters related to the Young's modulus of the tissue as well as the condition of fine blood flow and perforating vessels were calculated.Using histopathological results as the gold standard to construct receiver operating characteristic(ROC)curves,observe the effectiveness of SWE combined with SMI in the differential diagnosis of thyroid nodules,and compare the efficacy of different examination methods in the diagnosis of thyroid nodules.Results There were significant differences in the internal composition,echo,margin,cal-cification,and aspect ratio between the benign and malignant thyroid nodules(all P<0.05);however,there was no significant difference in the average diameter of the benign and malignant nodules(P>0.05).There were statistically significant differences in maximum elas-ticity,mean elasticity,elasticity ratio,microvascular score,peak shear wave velocity,and average shear wave velocity between the benign and malignant thyroid nodules(all P<0.05).The ROC curve showed that the area under the curve of the maximum elastic value was the highest,while the optimal diagnostic threshold was 29.52 kPa.The optimal diagnostic threshold for the microvascular flow score was 2.3 points.In terms of diagnostic efficacy,SWE combined with SMI showed the highest sensitivity(94.67%)and specificity(94.59%).Conclusion SWE combined with SMI can further improve the diagnostic efficiency of benign and malignant thyroid nodules and achieve quantitative evaluation and dynamic observation of lesions,which has application and promotion value.关键词
剪切波弹性成像/超微血管成像/甲状腺结节/良性/恶性/鉴别诊断Key words
shear wave elastography/superb microvascular imaging/thyroid nodule/benign/malignant/differential diagnosis分类
医药卫生引用本文复制引用
武林松,王冬,彭艳艳,庄浩泽,张冰冰,曲琪,申金付..SWE联合SMI在甲状腺良恶性结节鉴别诊断中的应用[J].中国医科大学学报,2024,53(6):541-546,6.基金项目
安徽省卫生健康适宜技术推广项目(SYJS202123) （SYJS202123）
阜阳市科学技术局项目(FK202081045) （FK202081045）
