高频超声联合萤火虫成像技术在甲状腺结节良恶性诊断中的应用价值

doi:10.3760/cma.j.cn101202-20201020-00362

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1583 KB) HTML (2 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨高频超声联合萤火虫成像技术在甲状腺结节良恶性诊断中的应用价值。方法回顾性研究。纳入2019年9月—2020年9月蚌埠医学院第一附属医院甲状腺结节患者100例(126个结节),其中男42例、女58例,年龄19~56岁。患者术前均行高频超声和萤火虫成像检查,术后均行病理组织学检查并确诊结节的良恶性。观察指标:(1)分析高频超声与萤火虫成像技术的超声图像特点以及图像质量;(2)比较两种不同成像方式下甲状腺恶性结节内微钙化的检出率;(3)比较高频超声与高频-萤火虫联合成像方式诊断甲状腺结节良恶性受试者操作特征曲线下面积(AUC)。结果 126个结节中,病理诊断为恶性者68个、良性者58个,高频超声图像显示恶性结节76个、良性结节50个,高频超声联合萤火虫成像显示恶性结节72个、良性结节54个。(1)甲状腺恶性结节中的微钙化在高频超声图像上多呈簇状散在分布的点状强回声;萤火虫成像模式下微钙化显示更加清晰明亮,但数量普遍少于高频超声图像上显示的微钙化数量。(2)萤火虫成像恶性结节中微钙化的检出率86.8%(59/68),高于高频超声检出率72.1%(49/68),两者比较差异有统计学意义(χ²=22.785, P＜0.05)。(3)高频超声诊断甲状腺结节良恶性的AUC为0.755,高频-荧火虫联合成像诊断甲状腺结节良恶性的AUC为0.918,差异有统计学意义(Z=3.937, P＜0.05)。高频超声联合萤火虫成像诊断甲状腺良恶性结节的灵敏度、特异度、准确度分别为95.6%、87.9%、92.1%。结论萤火虫成像技术较高频超声的甲状腺癌微钙化检出率更高,显示效果更好,两者联合应用诊断甲状腺结节良恶性准确度更高。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	郭飞飞
	刘娣
	侯迎迎
	李阳
	苏蕾
	郭婕
	孙医学

关键词 ：甲状腺结节, 超声检查, 钙化, 萤火虫成像技术

Abstract：Objective A study was conducted to explore the application value of high-frequency ultrasound combined with MicroPure technology in the differential diagnosis of benign and malignant thyroid nodules. Methods A retrospective study was conducted. A total of 100 patients with thyroid nodule (126 nodules) who were admitted into the First Affiliated Hospital of Bengbu Medical College from November 2019 to September 2020 were included. The patients comprised 42 males and 58 females, aged 19-56 years old. All patients received preoperative high frequency ultrasound and MicroPure imaging examination and were diagnosed as benign and malignant by pathology after surgery. (1) The ultrasound image features and the image quality of high frequency ultrasound and MicroPure technique were analyzed. (2) The detection rates of microcalcification in thyroid malignant nodules by the two different imaging methods were compared. (3) Area under the curve (AUC) of the diagnosis of benign and malignant thyroid nodules by using high frequency ultrasound and combined imaging methods were compared. Results Among the 126 nodules, 68 were malignant, and 58 were benign. Ultrasonic diagnosis results were as follows. High frequency ultrasound images showed 76 malignant and 50 benign nodules. High frequency ultrasound combined with MicroPure imaging showed 72 malignant and 54 benign nodules. (1) On high frequency ultrasound images, the microcalcifications of malignant thyroid nodules were mostly distributed in clusters and dotted with strong echo. In the MicroPure imaging mode, the microcalcifications were clearer and brighter, but the number of microcalcifications was generally less than those shown on high frequency ultrasound images. (2) Among malignant nodules, the detection rate of microcalcifications by MicroPure technology was 86.8% (59/68), which was higher than that by high frequency ultrasound 72.1%(49/68), and the difference between the two was statistically significant (χ²=22.785, P＜0.05). (3) The AUC of high frequency ultrasound combined and high frequency with MicroPure imaging in the diagnosis of benign and malignant thyroid nodules were 0.918 ,and 0.755, respectively, and the differences was statistically significant (Z=3.937, P＜0.05). The sensitivity, specificity, and accuracy of high frequency ultrasound combined with MicroPure imaging in the diagnosis of benign and malignant thyroid nodules were 87.9%, 95.6%, 92.1%, respectively. Conclusions The detection rate of microcalcification of thyroid cancer by MicroPure technology is higher than that by high frequency ultrasound. Moreover, the display effect is better, and the combined diagnosis of benign and malignant thyroid nodules have higher accuracy.

Key words： Thyroid nodule Ultrasonography Calcification Micropure technology

收稿日期: 2020-10-20

基金资助:安徽省高校自然科学研究项目(KJ2018A1003)

通讯作者: 孙医学,Email:13309621158@163.com

引用本文:

郭飞飞, 刘娣, 侯迎迎, 李阳, 苏蕾, 郭婕, 孙医学. 高频超声联合萤火虫成像技术在甲状腺结节良恶性诊断中的应用价值[J]. 中华解剖与临床杂志, 2021, 26(2): 144-148.
Guo Feifei, Liu Di, Hou Yingying, Li Yang, Su Lei, Guo Jie, Sun Yixue. The value of high frequency ultrasound combined with MicroPure technology in the diagnosis of thyroid nodule. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 144-148.

链接本文:

http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20201020-00362 或 http://www.cjac.com.cn/CN/Y2021/V26/I2/144

[1]	赵洁, 黄美玲, 易军.难治性甲状腺癌的精准靶向治疗进展[J]. 癌症进展, 2018, 16(6): 678-682. DOI:10.11877/j.issn.1672-1535.2018.16.06.04.
[2]	Wang N, Xu Y, Ge C, et al. Association of sonographically detected calcification with thyroid carcinoma[J]. Head Neck, 2006, 28(12): 1077-1083. DOI:10.1002/hed.20481.
[3]	中国医师协会超声医师分会.中国浅表器官超声检查指南[M]. 北京: 人民卫生出版社, 2017: 115-116.
[4]	梁杏芬, 杨璞, 黎天明, 等. 超声弹性成像应变率比值法联合“萤火虫”成像技术诊断甲状腺良恶性结节的价值[J]. 临床超声医学杂志, 2018, 20(3): 204-206. DOI:10.3969/j.issn.1008-6978.2018.03.023.Liang XF, Yang P, Li TM, et al. Value of strain ratio of ultrasound elastography combined with micropure imaging in differential diagnosis of benign and malignant thyroid nodules[J]. Ultrasound in Med, 2018, 20(3): 204-206. DOI:10.3969/j.issn.1008-6978.2018.03.023.
[5]	Sun Y, Fang S, Dong H, et al. Correlation between osteopontin messenger RNA expression and microcalcification shown on sonography in papillary thyroid carcinoma[J]. J Ultrasound Med, 2011, 30(6): 765-771. DOI:10.7863/jum.2011.30.6.765.
[6]	Kang KH.Osteopontin expression in papillary thyroid carcinoma and its relationship with the BRAF mutation and tumor characteristics[J]. J Korean Surg Soc, 2013, 84(1): 9-17. DOI:10.4174/jkss.2013.84.1.9.
[7]	毕腾云, 白文坤, 胡兵.甲状腺超声钙化形态与甲状腺癌的关系[J]. 中国超声医学杂志, 2016, 32(6): 481-483. DOI:10.3969/j.issn.1002-0101.2016.06.001.Bi TY, Bai WK, Hu B.Study of relationship between thyroid calcification morphology on ultrasound and thyroid carcinoma[J]. Chinese J Ultrasound Med, 2016, 32(6): 481-483. DOI:10.3969/j.issn.1002-0101.2016.06.001.
[8]	Remonti LR, Kramer CK, Leit ão CB , et al. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies[J]. Thyroid, 2015, 25(5): 538-550. DOI:10.1089/thy.2014.0353.
[9]	Machado P, Eisenbrey JR, Cavanaugh B, et al. Microcalcifications versus artifacts: initial evaluation of a new ultrasound image processing technique to identify breast microcalcifications in a screening population[J]. Ultrasound Med Biol, 2014, 40(9): 2321-2324. DOI:10.1016/j.ultrasmedbio.2014.04.008.
[10]	Park AY, Seo BK, Cho KR, et al. The utility of MicroPureTM ultrasound technique in assessing grouped microcalcifications without a mass on mammography[J]. J Breast Cancer, 2016, 19(1): 83-86. DOI:10.4048/jbc.2016.19.1.83.
[11]	郭莉, 赵青, 葛妍, 等. 常规超声及超声“萤火虫”成像技术诊断乳腺肿块微钙化的价值研究[J]. 新疆医科大学学报, 2018, 41(7): 839-841. DOI:10.3969/j.issn.1009-5551.2018.07.008.Guo L, Zhao Q, Ge Y, et al. The value of conventional ultrasound and ultrasound “firefly” imaging in the diagnosis of breast lumps microcalcification[J]. Journal of Xinjiang Medical University, 2018, 41(7): 839-841. DOI:10.3969/j.issn.1009-5551.2018.07.008.
[12]	Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee[J]. J Am Coll Radiol, 2017, 14(5): 587-595. DOI:10.1016/j.jacr.2017.01.046.
[13]	田艳, 鲁瑶, 赵玉珍, 等. 甲状腺乳头状癌微钙化高分辨率超声特征分析[J]. 中国医学科学院学报, 2018, 40(3): 378-384. DOI:10.3881/j.issn.1000-503X.2018.03.014.Tian Y, Lu Y, Zhao YZ, et al. Characteristics of high-resolution ultrasound in the assessment of microcalcification of papillary thyroid carcinoma[J]. Acta Academiae Medicinae Sinicae, 2018, 40(3): 378-384. DOI:10.3881/j.issn.1000-503X.2018.03.014.
[14]	马丽芬, 张耀仁, 苏振丽, 等. 甲状腺结节钙化模式与甲状腺癌的相关性分析[J]. 实用癌症杂志, 2015, 30(10): 1504-1506. DOI:10.3969/j.issn.1001-5930.2015.10.023.Ma LF, Zhang YR, Su ZL, et al. Analysis of correlation between thyroid nodules calcification patterns and thyroid cancer[J]. The Practical Journal of Cancer, 2015, 30(10): 1504-1506. DOI:10.3969/j.issn.1001-5930.2015.10.023.
[15]	Rios, Torregrosa, B, et al. Ultrasonographic risk factors of malignancy in thyroid nodules.[J]. Langenbecks Arch Surg, 2016, 401(6): 839-849. DOI:10.1007/s00423-016-1451-y.