TI-RADS4级桥本甲状腺炎合并甲状腺结节患者SWE技术弹性模量量化参数变化意义

doi:10.7517/issn.1674-0475.210121

摘要/Abstract

摘要： 本文探讨剪切波弹性成像（SWE）技术弹性模量量化参数对TI-RADS 4级桥本甲状腺炎（HT）合并甲状腺结节性质的鉴别效能，以及与恶性结节生物学行为的关系。选取312例（356个结节）甲状腺手术前超声检查发现可疑结节的TI-RADS 4级HT合并甲状腺结节患者，其中，良性结节215个，恶性结节141个。结果显示，恶性结节Emean、Emax、Esd及血管新生基因（VEGF、COX-2、Gal-3）、增殖基因（BRAF、TPX2、MCM7）、侵袭基因（Sixl）的mRNA高于良性结节（P<0.05）；Emean、Emax、Esd联合鉴别恶性结节的AUC值高于单独诊断价值；恶性结节VEGF、COX-2、Gal-3、BRAF、TPX2、MCM7、Sixl的mRNA与Emean、Emax、Esd呈正相关关系，BRMSI、TSHR、CCNG2、P53、PTEN的mRNA与Emean、Emax、Esd呈负相关关系（P<0.05）。SWE技术弹性模量量化参数Emean、Emax、Esd对甲状腺结节的良恶性有很好的鉴别诊断价值，且具体水平可反映恶性结节血管生成及癌细胞增殖、侵袭活性，可为患者临床诊治及预后评估提供参考。

关键词: 剪切波弹性成像, 弹性模量, 桥本甲状腺炎, 甲状腺结节, TI-RADS4级, 生物学行为

Abstract: The purpose of this study was to investigate the effect of shear wave elastography (SWE) elastic modulus quantification parameters on the differentiation of TI-RADS4 Hashimoto's thyroiditis (HT) with thyroid nodules and its relationship with the biological behavior of malignant nodules. Selected 312 patients (356 nodules) who found suspicious nodules in TI-RADS 4 HT combined with thyroid nodules before thyroid surgery, 215 benign nodules, and malignant nodules 141, malignant nodules Emean, Emax, Esd and angiogenesis genes (VEGF, COX-2, Gal-3), proliferation genes (BRAF, TPX2, MCM7), invasion genes (Sixl) mRNA are higher than benign nodules (P<0.05). The AUC value of Emean, Emax and Esd in differentiating malignant nodules was higher than that of single diagnosis. The mRNA of VEGF, COX-2, Gal-3, BRAF, TPX2, MCM7 and Sixl in malignant nodules were positively correlated with Emean, Emax and Esd, while the mRNA of BRMSI, TSHR, CCNG2, P53 and PTEN were negatively correlated with Emean, Emax and Esd (P<0.05). The elastic modulus parameters Emean, Emax and Esd of SWE technology have a good differential diagnosis value for benign and malignant thyroid nodules, and the specific level can reflect the angiogenesis, cancer cell proliferation and invasive activity of malignant nodules, which can provide reference for clinical diagnosis and treatment and prognosis evaluation of patients.

Key words: shear wave elastography, elastic modulus, Hashimoto thyroiditis, thyroid nodules, TI-RADS grade 4, biological behavior

赵恒达, 王怡. TI-RADS4级桥本甲状腺炎合并甲状腺结节患者SWE技术弹性模量量化参数变化意义[J]. 影像科学与光化学, 2021, 39(5): 689-694.

ZHAO Hengda, WANG Yi. Significance of Changes in Quantitative Parameters of Elastic Modulus of SWE Technique in Patients with TI-RADS Grade 4 Hashimoto's Thyroiditis and Thyroid Nodules[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(5): 689-694.

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