The Diagnostic Value Of Two Dimensional Ulasound Combined With Virtual Touch Tissues Quantification Of Thyroid Nodules

BackgroundAccording to the epidemiological statistics,the detection rate of thyroid nodules was19%⁶7%,and the rate of thyroid carcinoma was 5%¹0%^[1].Thyroid carcinoma occurs more frequently in female patients,is a common endocrine system tumor,and the incidence of thyroid cancer has increased significantly in recent years.With the improve-ment of the quality of thyroid ultrasound imaging and the increasing of the imaging infor-mation,the sensitivity of ultrasound on thyroid nodules is the highest,about 74%⁸1%^[2].And no trauma,no radiation,low cost,has become the preferred examination method of thyroid examination.This paper focuses on the study of two-dimensional ultrasound and acoustic touch tissues quantification?VTQ?obtained SWV value,and explore the diagnostic value of them in distinguishing benign from malignant thyroid nodules.And to explore the adjust-ment method which combined two-dimensional ultrasound and SWV value,looking for-ward to further improve the accuracy of diagnosis of thyroid malignant nodules,so as to provide more accurate guidance for clinical diagnosis and treatment.Objective1.To Investigate the value of two-dimensional ultrasound in the differential diagnosis of malignant and benign thyroid nodules.2.To investigate the value of SWV in the differential diagnosis of benign and malig-nant thyroid nodules,and to identify the boundary point of the best diagnosis in the diffe-rential diagnosis of benign and malignant thyroid nodules.3.To investigate the value of two-dimensional ultrasound combined with SWV in the diagnosis of benign and malignant thyroid nodules.Method1.The first part collected from May 2015 to December 2015 of ultrasonic exami-nation revealed thyroid nodule,80 patients with 100 nodules were selected according to the condition.All nodules were assessed by two-dimensional ultrasound before surgery,and compared with pathological results.All cases were confirmed by postoperative pathology.According to the malignant degree of nodule,from low to high in turn divided into A,B,C,D four groups,and compared with pathological results,and drawn ROC curve,with the size of the AUC to evaluate the value of two-dimensional ultrasound in the differential diagno-sis of benign and malignant thyroid nodules.2.The research object of second part is that 80 patients with 100 nodules and 25 cases of normal control group,were examined by Sound tissue palpation quantitative techniques,obtained Shear wave velocity values of thyroid benign nodules,malignant nodules and normal thyroid tissues.Comparison with pathologic results,ROC curve was drawn,through the area under the ROC curve evaluate the value of shear wave velocity in the differential diagnosis of benign and malignant thyroid nodules,and divided the boun-dary points of the shear wave velocity of benign and malignant thyroid nodules.3.Reference the results obtained from the second part of the study obtained the boundary points of the shear wave velocity between thyroid benign and malignant nodules,when the shear wave velocity more than the reference boundary,group A of nodules up to group B,group B of nodules rose to group C,when the shear wave velocity is less than or equal to the reference boundary,group C of nodules decreased to group B,group B of nodules decreased to group A.The nodules in the group D were not adjusted.Then com-pared with pathological results,drawn the ROC curve,according to different of AUC,by means of Z test,compare the different diagnostic value of thyroid nodules of the original two-dimensional ultrasound group and the two dimensional ultrasound group combined with shear wave velocity values.Results1.In 100 thyroid nodules,65 malignant nodules:56 thyroid papillary carcinoma,5 th-yroid follicular carcinoma,4 medullary thyroid carcinoma,35 benign nodules:22 nodular goiter and 13 thyroid adenoma.According to the grouping of two-dimensional ultrasound and compared with pathological results,the ROC curve was drawn,the AUC was 0.899,the sensitivity was 89.2%,the specificity was 80.0%.2.The shear wave velocity values of normal thyroid group,benign nodule group and malignant nodule group were?1.30?0.17?m/s,?2.61?1.15?m/s,?3.96?1.31?m/s,benign and malignant two groups compared with significant difference?P<0.05?.By drawing the ROC curve,the optimal diagnostic critical point of SWV was 2.96m/s,the area under the curve was 0.88,the corresponding sensitivity and specificity were 93.2%,72.1%.3.According to the improved two dimensional ultrasound group and compared with the pathological results,the ROC curve was drawn,AUC was 0.935,the specificity was91.4%,and the sensitivity was 93.8%.By means of Z test,the AUC of the modified two-dimensional ultrasound grouping and original two dimensional ultrasound grouping were different,the difference was statistically significant between the two groups.The value of two-dimensional ultrasound combined with VTQ technique in the diagnosis of benign and malignant thyroid nodules is superior to the independent diagnostic value of two-dimen-sional ultrasound and VTQ technology.ConclusionThe value of two-dimensional ultrasound combined with VTQ technique in the diagn-osis of benign and malignant thyroid nodules is superior to the independent diagnostic value of two-dimensional ultrasound and VTQ technology.