Value of Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Thyroid Nodules
Value of Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Thyroid Nodules
复制标题
超声造影和声辐射力脉冲成像对甲状腺良恶性结节的鉴别诊断价值
DOI：
10.3389/fphar.2018.01363
复制
发表时间：
2018-11-27
影响因子：
5.6
通讯作者：
Wei, Hai Ming
中科院分区：
文献类型：
--
作者：
He, Yan;Wang, Xiao Yan;Wei, Hai Ming
目的：探讨超声造影（CEUS）和声辐射力脉冲成像（ARFI）对甲状腺良恶性结节的鉴别诊断价值。方法：对88例甲状腺结节进行超声造影检查。分析超声造影模式，然后进行ARFI。测量结节及周围正常甲状腺组织的横波速度（SWVs）。通过受试者工作特征（ROC）曲线分析获得曲线下面积（auc）和截止值。采用病理诊断方法对各模式的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及诊断率进行比较。结果：88例结节中，恶性29例，良性59例。超声造影的敏感性、特异性、PPV、NPV和诊断率分别为79.3、91.5、82.1、90和87.5%。SWV的临界值为2.565 m/s，对恶性肿瘤的敏感性、特异性、PPV、NPV和诊断率分别为75.9、94.9、88.0、88.9和88.6%。AUC为0.878。CEUS联合ARFI的敏感性、特异性、PPV、NPV和诊断率分别为93.1、89.8、81.8、96.3和90.9%。结论：超声造影和ARFI对甲状腺良恶性结节的鉴别诊断具有重要价值。两种方法相结合可提高诊断率。
Objectives: To assess the value of contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) imaging for the differential diagnosis of benign and malignant thyroid nodules. Methods: CEUS was performed in eighty-eight thyroid nodules. The patterns of CEUS were analyzed, and ARFI was then performed. The shear wave velocities (SWVs) of the nodules and the surrounding normal thyroid tissue were obtained. The areas under the curve (AUCs) and cut-off value were obtained by a receiver operating characteristic (ROC) curve analysis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic rate of each modality were assessed and compared using pathological diagnosis. Results: Among 88 nodules, 29 nodules were malignant and 59 were benign. The sensitivity, specificity, PPV, NPV, and diagnostic rate of CEUS were 79.3, 91.5, 82.1, 90, and 87.5%, respectively. Using a cut-off value of 2.565 m/s for SWV, the sensitivity, specificity, PPV, NPV and diagnostic rate for malignancy were 75.9, 94.9, 88.0, 88.9, and 88.6%, respectively. The AUC was 0.878. The sensitivity, specificity, PPV, NPV and diagnostic rate of CEUS in combination with ARFI were 93.1, 89.8, 81.8, 96.3, and 90.9%, respectively. Conclusion: Both CEUS and ARFI are valuable for the differential diagnosis of benign and malignant thyroid nodules. Combining these two methods can improve the diagnostic rate.