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目的 :评价灰阶超声和声脉冲辐射力成像-声触诊组织定量(acoustic radiation force impulse-virtual touch quantification,ARFI-VTQ)技术对最大径小于1 cm的甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的诊断价值。方法 :收集195例病理诊断明确的最大径小于1 cm的甲状腺结节的灰阶超声和ARFI-VTQ弹性超声声像资料,回顾性分析2种超声检查方法的诊断价值。结果 :195个甲状腺小结节中,甲状腺乳头状癌92个,良性结节103个。灰阶超声的纵横比、边界、声晕及侧方声影对PTMC有重要的诊断价值,灰阶超声诊断的敏感度为77.2%,特异度为80.6%,准确度为79.0%,阳性预测值为78.0%,阴性预测值为79.8%。采用ARFI判定结节的性质,当VTQ的剪切波速度(shear wave velocity,SWV)临界值为2.98 m/s时,敏感度为72.8%,特异度为77.7%,准确度为75.2%,阳性预测值为76.5%,阴性预测值为74.1%。2种超声检查方法的总体诊断价值无明显差异。结论:对最大径小于1 cm的PTMC应以灰阶超声检查为基础,联合ARFI-VTQ能够增强诊断的信心。
Objective: To evaluate the effect of gray-scale ultrasound and acoustic pulse radiation imaging (ARFI-VTQ) on the papillary thyroid microcarcinoma PTMC) diagnostic value. Methods: 195 cases of pathologically confirmed thyroid nodules with maximum diameter less than 1 cm were collected by gray scale ultrasound and ARFI-VTQ elastography. The diagnostic value of two kinds of ultrasonography was retrospectively analyzed. Results: Among 195 small thyroid nodules, there were 92 thyroid papillary carcinomas and 103 benign ones. Aspect ratio, border, sound halo and lateral sound shadow of gray scale ultrasound have important diagnostic value for PTMC. The sensitivity, specificity and accuracy of gray scale ultrasound are 77.2%, 80.6% and 79.0%, respectively. The positive predictive value 78.0%, negative predictive value of 79.8%. ARFI was used to determine the nodules. When the cut-off value of shear wave velocity (SWV) of VTQ was 2.98 m / s, the sensitivity was 72.8%, the specificity was 77.7% and the accuracy was 75.2% The predicted value was 76.5% and the negative predictive value was 74.1%. There was no significant difference in the overall diagnostic value of the two sonographic methods. CONCLUSIONS: PTMCs with a maximum diameter of less than 1 cm should be based on gray-scale ultrasonography and combined with ARFI-VTQ can enhance diagnostic confidence.