摘要
目的评估横切面和纵切面对剪切波弹性成像(shear wave elastography,SWE)测量甲状腺结节硬度的影响。方法选取2022年2月至2022年11月在山东第一医科大学第一附属医院行SWE检查的67例甲状腺结节患者(79枚结节),所有患者均经穿刺活检或手术取得病理结果,依据病理结果将结节分为良性和恶性。比较良恶性结节横纵两切面的弹性模量最大值(maximum elastic modulus,Emax)、弹性模量平均值(mean elastic modulus,Emean),构建受试者工作特征(receiver operating characteristic,ROC)曲线,并应用曲线下面积(area under the curve,AUC)分析不同切面方向的SWE对甲状腺结节良恶性的诊断效能;采用Cronbach信度和Bland-Altman图分析SWE横切面和纵切面2个方向对诊断甲状腺结节的可靠性和一致性。结果甲状腺恶性结节的横切面和纵切面弹性模量值均高于良性结节。对于良性结节,横切面及纵切面的Emax值、Emean值的差异均无统计学意义(P>0.05);对于恶性结节,横切面及纵切面的Emax值均大于Emean值,2个值的差异有统计学意义(P<0.05)。ROC曲线分析表明,纵向SWE的Emax、Emean,横向SWE的Emax、Emean的AUC分别为0.955、0.939、0.942、0.930,2个指标的AUC的诊断性能差异无统计学意义(P>0.05)。79枚甲状腺结节横切面和纵切面SWE的Emax和Emean的Cronbach信度分析表明具有良好的相关关系(信度系数值为0.941,0.943),Bland-Altman图直观表明,横切面和纵切面的弹性模量值在很大范围内几乎没有偏差,说明数据具有良好的一致性水平。结论切面方向(横切面和纵切面)对SWE测量甲状腺结节Emax和Emean具有良好的一致性和可靠性。2种成像方向的相似表现为有解剖或生理限制的患者成像提供了检查灵活性。
Objective:To assess the effect of transverse and longitudinal sections on shear wave elastography(SWE)measurements of thyroid nodule stiffness.Methods:A total of 67 patients(79 nodules)who underwent thyroid ultrasound examination in our hospital from February 2022 to November 2022 and underwent SWE examination for all nodules were included in this study.All patients had pathological results obtained through either fine-needle aspiration or surgical biopsy,which allowed the nodules to be classified as benign or malignant.The study aimed to compare the maximum elastic modulus(Emax)and mean elastic modulus(Emean)between benign and malignant nodules in both transverse and longitudinal shear wave elastography.Receiver operating characteristic(ROC)curves were constructed,and the area under the curve(AUC)was calculated to assess the diagnostic performance of SWE in different directions for distinguishing benign and malignant thyroid nodules.The Cronbach reliability coefficient and Bland-Altman plot were used to analyze the reliability and consistency of SWE in both transverse and longitudinal directions for diagnosing thyroid nodules.Results:The transverse and longitudinal elastic modulus values of malignant thyroid nodules were higher than those of benign nodules.The differences in Emax and Emean values in transverse and longitudinal sections were not statistically significant for benign nodules,but they were statistically significant for malignant nodules.The ROC analysis showed that the AUC values for Journal of Shandong First Medical University&Shandong Academy of Medical Sciences,December 2023,Vol.44 No.12 Emax and Emean in longitudinal shear wave elastography were 0.955 and 0.939,respectively,while the AUC values for Emax and Emean in transverse shear wave elastography were 0.942 and 0.930,respectively.There was no statistically significant difference in the diagnostic performance(AUC)between these two measurements.Cronbach's reliability analysis of Emax and Emean for SWE in cross-sectional and longitudinal sections of 79 thyroid nodules showed a good correlation(reliability coefficient values of 0.941,0.943).The Bland-Altman plots visually showed that the values of the elastic modulus in the transverse and longitudinal sections had almost no deviation over a wide range,indicating a good level of agreement in the data.Conclusion:The section orientation(transverse and longitudinal sections)shows good agreement and reliability for SWE measurements of maximum and mean modulus values of thyroid nodules.The similar performance of the two imaging orientations provides examination flexibility for imaging patients with anatomical or physiological limitations.
作者
张鑫茹
马喆
徐帅娅
巴晨曦
孙萌
ZHANG Xinru;MA Zhe;XU Shuaiya;BA Chenxi;SUN Meng(Department of Medical Ultrasound,The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Jinan 250014,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2023年第12期900-903,共4页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
