【摘要】 目的 探讨弹性成像在甲状腺微小癌诊断中的应用价值。 方法 回顾性分析从2007年12月-2008年4月间经病理证实的10例甲状腺微小癌患者共11个病灶的超声表现。 结果 彩色多普勒超声诊断甲状腺微小癌8例8个病灶，利用弹性成像技术诊断10例10灶。传统彩色多普勒超声对甲状腺微小癌的诊断率为72.7%；利用弹性成像技术对甲状腺微小癌的诊断率为90.9%。 结论 弹性成像技术对于甲状腺微小癌是对彩色多普勒超声检查的有益的补充，能够显著提高超声对甲状腺微小癌诊断的准确性。【Abstract】 Objective To evaluate the application of US-elastography in diagnosis of thyroid microcacinoma. Methods The images of color ultrasound and ultrasound elastography from 11 lesions of 10 patients with thyroid micro-carcinoma diagnosed via histopathology between December 2007 and April 2008 were retrospectively analyzed. Results Eight patients with eight lesions were found by colour ultrasound and 10 patients with 10 lesions were observed by ultrasound elastography. The diagnosis accurate rate of ultrasonography was about 72.7% and of ultrasound elastography was about 90.0%. Conclusion US-Elastography is a beneficial addition in diagnosis of thyroid microcacinoma by colour ultrasound. It can remarkably develop the accurate rate of the diagnosis of the disease.
【摘要】目的探讨实时超声弹性成像在淋巴结疾病诊断中的应用价值。 方法分析2008年2月4月27例淋巴结疾病患者的65个淋巴结病灶超声弹性图表现,弹性图分级为0~Ⅳ级,弹性图分型为Ⅰ~Ⅲ型。所有淋巴结均经术后病理学或细针抽吸细胞学检查证实,或经随访证实。结果转移性淋巴结弹性分级较高,≥Ⅲ级11/13,占84.62％;淋巴瘤性淋巴结弹性分级较低,≤Ⅱ级16/21,占76.19％。转移性淋巴结中Ⅱ型7/13,占53.85％,转移性淋巴结占全部Ⅱb型的54.55%(6/11);淋巴瘤性淋巴结中Ⅱ型13/21,占61.90％,淋巴瘤性淋巴结占全部Ⅱa型的73.33％(11/15);反应性淋巴结占全部Ⅰa型的68.18％(15/22)。结论实时超声弹性成像能为淋巴结疾病的诊断提供一定信息,弹性图分级对鉴别良恶性淋巴结有统计学意义,分型对于鉴别特定类型淋巴结疾病有一定提示作用。
ObjectiveTo evaluate the clinical value of ultrasonic elastosonography in the diagnosis of thyroid nodules. MethodsThe elastosonography images of 119 thyroid nodules in 71 patients treated between February 2010 and February 2013 were analyzed and the hardness of the nodule was classified into five grades according to the results of elastosonography. It was defined that the nodules with grade 0-Ⅱ hardness were benign while those with grade Ⅲ-Ⅳ were malignant. The results of elastosonography were compared with surgery and pathology. ResultsIn these patients, the number of benign and malignant thyroid nodules were 102 and 17, respectively according to pathology. The sensitivity, specificity and accuracy of elastosonography in the diagnosis of thyroid nodules were respectively 100.0%, 73.5% and 77.3%. ConclusionUltrasonic elastosonography is helpful in the diagnosis between benign and malignant thyroid nodules; the combined elastosonography and conventional ultrasound can improve diagnostic accuracy.
ObjectiveTo systematically review the clinical value of ultrasonographic elastography (UE) for the differential diagnosis of benign/malignant thyroid nodules. MethodsWe comprehensively searched the databases including The Cochrane Library (Issue2, 2013), PubMed, EMbase, CNKI, WanFang Data, Medalink, VIP and CBM from inception to the December of 2013, for including clinical research reports of determining thyroid nodules using ultrasonographic elastography. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Then Meta-DiSc software (version 1.4) was used for pooling analysis. ResultsA total of 35 studies including 4 127 patients were included. The results of metaanalysis showed that, specificity, sensitivity, positive likelihood radio, negative likelihood radio and diagnostic odds ratio (DOR) were 0.89 (0.88 to 0.90), 0.88 (0.86 to 0.90), 6.37 (5.44 to7.47), 0.13 (0.11 to 0.16) and 58.72 (43.12 to 79.98), respectively; and the area under SROC curve (AUC) was 0.936 9. ConclusionCurrent evidence shows that ultrasonographic elastography has fairly high sensitivity (88%) and specificity (89%) in differential diagnosis of benign/malignant thyroid nodules. The positive rate in the malignant thyroid group is 58.72 times higher that in benign thyroid cancer with better efficacy in differential diagnosis, so ultrasonographic elastography is of effective and feasible diagnostic value for thyroid benign/malignant nodules.
ObjectiveTo systematically review the diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer.MethodsWe electronically searched the databases including The Cochrane Library, PubMed, CNKI, WanFang Data, VIP, MedaLink and CBM for studies about diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer from inception to October 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then meta-analysis was performed using MetaDisc 1.4 software.ResultsA total of 9 studies involving 735 lymph nodes were included. The results of meta-analysis showed that, the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio and DOR were 0.82 (95%CI 0.78 to 0.86), 0.76 (95%CI 0.72 to 0.81), 3.32 (95%CI 2.57 to 4.27), 0.25 (95%CI 0.20 to 0.31), and 14.77 (95%CI 10.20 to 21.38), respectively. The AUC of the SROC curve was 0.8741.ConclusionUltrasonographic elastography has high sensitivity and specificity in the differential diagnosis of axillary lymph nodes in breast cancer, which indicates that it can be used to diagnosis axillary lymph nodes in breast cancer.
Objective To evaluate the significance of the ultrasound elastography (UE) strain ratio (SR) in the diagnosis of breast nodule by meta-analysis. Methods A computer-based online search was conducted in PubMed, The Cochrane Library (Issue 6, 2017), EMbase, CNKI, VIP, CBM, WanFang data databases, and so on (establishment time to June 2017), to collect the relevant diagnostic trials of the SR for breast nodules. Two reviewers independently screened literatures, extracted data, and evaluated the methodological quality of included studies. The meta-analysis was performed by using Stata 12.0 and Meta-Disc 1.4 software, and the combined indexes included sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR+), negative likelihood ratio (LR–), and diagnostic odds ratio (DOR). Results A total of 26 studies were finally included. The results of meta-analysis showed that, the pooled Sen, Spe, LR+, LR–, and DOR was 0.88 (95% CI was 0.87 to 0.90), 0.85 (95% CI was 0.84 to 0.86), 6.66 (95% CI was 5.26 to 8.43), 0.14 (95% CI was 0.11 to 0.17), and 53.37 (95% CI was 34.96 to 81.49), respectively, P<0.000 1. Conclusion SR has high diagnostic accuracy in the differential diagnosis of benign and malignant breast nodules, it is worthy of widely utilized in the clinic.
ObjectiveTo explore the diagnostic value of ultrasound elastography (USE) combined with long non-coding RNA actin filament associated protein 1 anti-sense RNA 1 (AFAP1-AS1) mRNA in thyroid fine-needle aspiration (FNA) wash-out fluid for distinguishing benign from malignant thyroid nodules. MethodsThe patients with thyroid nodules who were treated in the Shenzhen Futian District Second People’s Hospital from January 2020 to June 2022 were collected. Before operation, the patients’ thyroid nodules were evaluated by the USE score and the AFAP1-AS1 mRNA in the thyroid FNA wash-out fluid was detected. The pathological result of the thyroid nodule after operation was as a gold standard for diagnosis of malignant thyroid nodules. The clinical diagnostic value of USE score combined with AFAP1-AS1 mRNA in the FNA wash-out fluid of the benign and malignant thyroid nodules were analyzed. ResultsA total of 174 thyroid nodules (124 patients) were detected in this study, of which 62 (45 patients) were histologically diagnosed as malignant. There was a statistical difference in the comparison of the composition ratio of USE score grading between the benign and malignant thyroid nodules (Z=8.82, P<0.001). The point of USE of the benign thyroid nodules was statistically lower than that of the malignant thyroid nodules [2.28±1.16 vs. 4.26±1.01, mean difference (MD) and 95% confidence interval (95%CI)=2.98 (2.76, 3.20), t=30.85, P<0.001]. The AFAP1-AS1 mRNA in the FNA wash-out fluid of the malignant thyroid nodules was statistically higher than that of the benign thyroid nodules [1.45±0.27 vs. 1.13±0.16, MD (95%CI)=1.45(1.39, 1.50), t=10.69, P<0.001]. Pearson correlation analysis showed that there was a positive correlation between the USE score of thyroid nodules and the expression of AFAP1-AS1 mRNA in the FNA wash-out fluid (r=0.58, P<0.001). The sensitivity and specificity of USE score in combination with expression of AFAP1-AS1 mRNA in the FNA wash-out fluid for diagnosing the malignant thyroid nodules by receiver operating characteristic (ROC) curve was 93.5% and 88.4% respectively. The area under the ROC curve (95%CI) was 0.91 (0.86, 0.96). Conclusion According to preliminary results of this study, USE score combined with AFAP1-AS1 mRNA in the thyroid FNA wash-out fluid is more sensitive and shows a potential diagnostic performance than USE score or AFAP1-AS1 mRNA detection alone for distinguishing benign from malignant thyroid nodules.