中文摘要：

目的探讨声触诊组织成像与定量（VTIQ）技术联合2015年美国甲状腺学会（ATA）指南在甲状腺良恶性结节鉴别诊断中的临床应用价值。方法选取2015年5—11月同济大学附属第十人民医院收治的甲状腺结节患者109例,共109个甲状腺结节。患者行常规甲状腺超声检查和VTIQ检查,并按照2015年ATA指南进行分组。以病理组织学检查结果为金标准,比较单独应用VTIQ检查、ATA指南以及两者联合应用诊断甲状腺良恶性结节的价值。结果 109个甲状腺结节中,良性结节65个,恶性结节44个。良恶性结节大小比较,差异无统计学意义（P〉0.05）;良亚性结节内部成分、回声、边缘、钙化、纵横比比较,差异均有统计学意义（P〈0.001）。良性结节剪切波速度（SWS）最大值、最小值、平均值均低于恶性结节（P〈0.001）;良恶性结节2015年ATA指南分组情况比较,差异有统计学意义（P〈0.001）。SWS最大值、最小值、平均值诊断甲状腺良恶性结节的受试者工作特征（ROC）曲线下面积（AUC）分别为0.834〔95%CI（0.758,0.911）〕、0.841〔95%CI（0.763,0.919）〕和0.861〔95%CI（0.790,0.933）〕,诊断界值分别为3.26、2.54、2.92 m/s。以SWS平均值2.92 m/s为诊断界值时,其诊断甲状腺良恶性结节的灵敏度、特异度及正确率分别为79.5%（35/44）、83.1%（54/65）和81.7%（89/109）。以极低度可疑恶性组诊断为甲状腺良性结节,低度可疑恶性组及以上（包括未描述组）诊断为甲状腺恶性结节,其诊断甲状腺良恶性结节的灵敏度、特异度及正确率分别为97.7%（43/44）、40.0%（26/65）和63.3%（69/109）,AUC为0.689〔95%CI（0.591,0.786）〕。将极低度可疑恶性组诊断为甲状腺良性结节,高度可疑恶性组诊断为甲状腺恶性结节,低度、中度可疑恶性组及未描述组则根据SWS平均值〈2.92 m/s诊断为甲状腺良性结节,SWS平均值≥2.92 m/s诊断为甲状腺恶性结节。

英文摘要：

Objective To assess the clinical application value of virtual touch tissue imaging quantification（ VTIQ）in combination with the 2015 guidelines of American Thyroid Association（ ATA） for differentiating benign thyroid nodules from malignant thyroid nodules. Methods 109 patients with thyroid nodules in the Tenth People＇ s Hospital Affiliated to Tongji University from May to November in 2015,were selected as study subjects,109 thyroid nodules were confirmed by pathology after surgery. Patients underwent conventional ultrasonic examinations and VTIQ examinations,and were grouped according to the2015 guidelines of ATA. Histopathological examination results were the gold standard,the values of simple application of VTIQ,simple application of 2015 guidelines of ATA, and application of VTIQ in combination with 2015 guidelines of ATA for differentiating malignant thyroid nodules from benign thyroid nodules were compared. Results There were 65 benign thyroid nodules and 44 malignant thyroid nodules among 109 thyroid nodules. There was not significant difference in diameter between benign thyroid nodules and malignant thyroid nodules（ P〈0. 05）; there were significant differences in ingredient, echo,nodule edge,calcification and aspect ratio between benign thyroid nodules and malignant thyroid nodules（ P〈0. 001）. The maximum value of SWS,the minimum value of SWS,and the average value of SWS of benign thyroid nodules were all lower than those of malignant thyroid nodules（ P〈0. 001）. There was significant difference in 2015 guidelines of ATA grouping situation between benign thyroid nodules and malignant thyroid nodules（ P〈0. 001）. For differentiating benign thyroid nodules from malignant thyroid nodules,the areas under the ROC curves（ AUC） for the maximum value of SWS,the minimum value of SWS and the average value of SWS was 0. 834 〔95% CI（ 0. 758,0. 911） 〕,0. 841 〔95% CI（ 0. 763,0. 919） 〕and 0. 861 〔95%CI（ 0. 790,0. 933） 〕,respectively,the diagnostic cut- off valu