SMI联合UE鉴别甲状腺结节的价值

doi:10.7517/issn.1674-0475.211102

摘要/Abstract

摘要： 本研究探讨超微血管显像(SMI)联合超声弹性成像(UE)鉴别甲状腺结节良恶性的价值。甲状腺结节患者均给予彩超、SMI及UE检查,分析诊断结果。80例患者共计122枚结节,恶性结节经SMI判断结节血流分型Ⅱ～Ⅲ级比例明显高于良性结节(P<0.05);恶性结节形态规则、内部囊性病变比例明显低于良性结节(P<0.05),而边界不清、纵横比≥1、低回声和内部钙化的比例明显高于良性结节(P<0.05);恶性结节应变率比值≥3.79、弹性评分4～5分的比例明显高于良性结节(P<0.05);SMI联合UE诊断甲状腺恶性结节的灵敏性和阴性预测值明显高于彩超联合UE诊断(P<0.05)。SMI联合UE有助于提高甲状腺结节良恶性鉴别能力,值得临床使用。

关键词: 超微血管显像, 超声弹性成像, 甲状腺结节, 良恶性

Abstract: The purpose of this study was to investigate the value of superb micro-vascular imaging (SMI) combined with ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid nodules. Ultrasound, SMI and UE examination were performed in patients with thyroid nodules and the diagnosis results were analyzed. Among the 122 nodules in 80 patients, The proportion of malignant nodules with blood flow classification of grade Ⅱ to Ⅲ by SMI was significantly higher than that of benign nodules (P<0.05). The proportion of malignant nodules with regular shape and internal cystic lesions was significantly lower than that of benign nodules (P<0.05), while the proportion of unclear boundary, aspect ratio ≥1, hypoechoic and internal calcification was significantly higher than that of benign nodules (P<0.05). The strain rate ratio ≥3.79, and the proportion of elastic score 4-5 of malignant nodules were significantly higher than those of benign nodules (P<0.05). The sensitivity and negative predictive value of SMI combined with UE in the diagnosis of thyroid malignant nodules were significantly higher than that of color ultrasound combined with UE (P<0.05). SMI combined with UE can improve the differentiation ability of benign and malignant thyroid nodules, which is worthy of clinical use.

Key words: superb micro-vascular imaging, ultrasonic elastography, thyroid nodule, benign and malignant

蔡淑云, 李唯. SMI联合UE鉴别甲状腺结节的价值[J]. 影像科学与光化学, 2022, 40(2): 409-413.

CAI Shuyun, LI Wei. Value of SMI Combined with UE in Differential Diagnosis of Benign and Malignant Thyroid Nodules[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(2): 409-413.

参考文献

[1] 吴金声, 郑起. 甲状腺结节的良恶性鉴别进展[J]. 国外医学(外科学分册), 2005, 32(4):297-300.
[2] 张玮婧, 张捷, 彭娟, 等. 超声综合评分法在不同大小甲状腺结节良恶性鉴别诊断中的价值[J]. 临床超声医学杂志, 2015, 17(1):21-23.
[3] 武宽, 秦品乐, 柴锐, 等. 基于不同超声成像的甲状腺结节良恶性判别[J]. 计算机应用, 2020, 40(1):77-82.
[4] 罗俊, 王刚. 超声弹性成像技术在甲状腺结节诊断中的应用价值[J]. 中国基层医药, 2020, 27(18):2196-2200.
[5] 孔晶, 杨薇, 金金, 等. 超微血管显像、能量多普勒及彩色多普勒血流显像对甲状腺结节的诊断价值比较[J]. 中华超声影像学杂志, 2018, 27(7):595-598.
[6] Chammas M C, Gerhard R, de Oliveira I R S, et al. Thyroid nodules:Evaluation with power Doppler and duplex Doppler ultrasound[J]. Otolaryngology-Head and Neck Surgery, 2005, 132(6):874-882.
[7] Moon W J, Jung S L, Lee J H, et al. Benign and malignant thyroid nodules:US differentiation-multicenter retrospective study[J]. Radiology, 2008, 247(3):762-770.
[8] Gao Z X, Lu Q, Yan J P. Value of differential diagnosis of contrast-enhanced ultrasound in benign and malignant thyroid nodules with microcalcification[J]. Oncology Letters, 2019, 17(5):4545-4549.
[9] Brkljacic B, Cuk V, Tomic-Brzac H, et al. Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids[J]. Journal of Clinical Ultrasound, 1994, 22(2):71-76.
[10] Fatima M, Younus S, Maqsood H, et al. Diagnostic accuracy of strain ultrasound elastography in differentiating benign and malignant thyroid nodules, taking histopathology as gold standard[J]. International Journal of Research in Medical Sciences, 2021, 9(2):347-353.
[11] Yan Y, Zhu W, Wu Y Y, et al. Fractal dimension differentiation between benign and malignant thyroid nodules from ultrasonography[J]. Applied Sciences, 2019, 9(7):1494-1495.
[12] Ito S, Tahara N, Hirakata S, et al. Signal intensity of superb micro-vascular imaging associates with the activity of vascular inflammation in Takayasu arteritis[J]. Journal of Nuclear Cardiology, 2020, 27(3):1063-1065.
[13] Tian C L, Wang Z N, Hou X K, et al. The diagnostic accuracy of superb microvascular imaging in distinguishing thyroid nodules:A protocol for systematic review and meta analysis[J]. Medicine, 2020, 99(40):e22350.
[14] Sui P, Wang X Y, Sun L P, et al. Diagnostic accuracy of ultrasound superb microvascular imaging for focal liver lesions:A protocol for systematic review and meta-analysis[J]. Medicine, 2021, 100(3):e24411.
[15] Wang C, Lin M X, Zhong L, et al. The value of TI-RADS combined with superb microvascular imaging in distinguishing thyroid nodules:A protocol for systematic review and meta-analysis[J]. PLoS One, 2021, 16(1):e0245035.
[16] Başer H, Topaloĝlu O, Fakı S, et al. Evaluation of malignancy with thyroid imaging reporting and data system (TI-RADS) in thyroid nodules with persistent nondiagnostic cytology[J]. Turkish Journal of Medical Sciences, 2019, 49(3):907-913.
[17] 李景, 石波. 二维高频超声联合实时超声弹性成像在甲状腺结节良恶性鉴别中的应用价值分析[J]. 医药前沿, 2019, 9(2):142-143.
[18] 巩彦星. 超声造影联合超声弹性成像在甲状腺结节良恶性病变的诊断价值[J]. 现代诊断与治疗, 2019, 30(21):3842-3845.
[19] 刘云飞. 超声弹性成像诊断甲状腺结节良恶性的应用价值[J]. 世界最新医学信息文摘(电子版), 2019, 19(84):234-235.
[20] 陈京喆, 张珂, 葛晖. 实时超声弹性成像在甲状腺结节早期鉴别诊断应用[J]. 中华养生保健, 2020, 38(5):194-195, 198."