超声造影联合声辐射力脉冲成像技术在甲状腺微小乳头状癌诊断中的研究

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Abstract Objective: To evaluate the value of contrast-enhanced ultrasound(CEUS) combined with acoustic radiation force pulse-imaging(ARFI) in the diagnosis of papillary thyroid microcarcinoma(PTMC). Methods: Conventional ultrasonography, CEUS and ARFI were performed in 496 patients with 564 suspicious thyroid nodules, and the results were compared with the gold standard after operation pathology. To evaluate the diagnostic efficacy of conventional ultrasound, CEUS and ARFI in PTMC, and to analyze the diagnostic value of shear wave conduction velocity(SWV) for PTMC by receiver operating characteristic(ROC) of curve area(AUC). Results: Of the 564 lesions, 306 were benign and 258 were malignant. PTMC ultrasound contrast showed concentric, inhomogeneous and low enhancement. The SWV and SWV ratios in the PTMC nodules were significantly higher than those in the thyroid nodules((5.92±3.25) m/s vs (2.02±0.93) m/s, 2.82±1.44 vs 1.05±0.46, all P<0.05). The sensitivity and specificity of CEUS and ARFI were better than that of conventional ultrasound in the diagnosis of PTMC, the combination of two methods for the diagnosis of PTMC was better, and the diagnostic sensitivity, specificity, positive predictive value and negative predictive value were 97.3%, 94.1%, 93.3%, 97.6%, respectively, and the accuracy could reach 95.6%. The ROC curve showed that the AUC and 95%CI of SWV in the diagnosis of PTMC was 0.894(0.836~0.958), the optimal threshold was 3.65 m/s, and the sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of PTMC were 87.3%, 90.6%, 92.3% and 85.7%, respectively. Conclusion: CEUS and ARFI are of great value in the diagnosis of PTMC, and the combination of two methods can improve the diagnostic accuracy.

Key words： Thyroid neoplasms Carcinoma, papillary Ultrasonography

Received: 19 June 2017

PACS:	Ｒ736.1
	Ｒ730.261
	Ｒ445.1

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	Articles by authors
	HE Yan-lian
	YU Yue-fen
	XU Xiao-lan
	SHU Ting
	FU Chun-rong
	LI Mei-fen

Cite this article:

HE Yan-lian,YU Yue-fen,XU Xiao-lan, et al. Study of contrast-enhanced ultrasound combined with acoustic radiation force impulse-imaging in the diagnosis of papillary thyroid micro-carcinoma[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(4): 250-253.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2018/V29/I4/250

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