目的：探讨常规超声与声触诊组织量化技术（ VTQ）鉴别诊断甲状腺良、恶性结节的价值。方法选取2012年2月—2014年10月在石河子大学医学院第一附属医院就诊以甲状腺结节（长径＞1 cm）收入院患者94例，均进行常规超声及VTQ检查，并行甲状腺切除术，经病理确诊。常规超声采用半定量评分法； VTQ定量测定结节内剪切波速度（ SWV），利用受试者工作特征（ ROC）曲线比较常规超声与VTQ诊断甲状腺恶性结节的效能。结果以病理检查为金标准，常规超声诊断甲状腺恶性结节的灵敏度、特异度、正确率分别为80.4％（41／51）、81.4％（35／43）、80.9％（76／94）。甲状腺恶性结节SWV高于甲状腺良性结节〔（3.29±1.20） m／s与（1.98±0.45） m／s〕（t＝-6.813， P＜0.001）。以SWV＝2.75 m／s为截断值， VTQ诊断甲状腺恶性结节的灵敏度、特异度、正确率分别为92.2％（47／51）、88.4％（38／43）、90.4％（85／94）。常规超声与VTQ诊断甲状腺恶性结节的ROC曲线下面积分别为0.804、0.918，差异有统计学意义（Z＝5.576， P＜0.001）。结论常规超声与VTQ均有助于鉴别诊断甲状腺良、恶性结节， VTQ明显优于常规超声。%Objective To explore the value of conventional ultrasound ( US) and virtual tough tissues quantification ( VTQ) technique in the identification and diagnosis of benign and malignant thyroid nodules.Methods We enrolled 94 patients with thyroid nodules ( long diameter>1 cm) who received treatment in the First Affiliated Hospital of the Medical College of Shihezi University from February 2012 to October 2014.The subjects all received US and VTQ examination, thyroidectomy, and pathological examinations.Semi-quantitative scoring method was employed in US examination.Shear wave velocity ( SWV) was used in VTQ examination.Receiver operating characteristic ( ROC) curves was employed to compare the effectiveness in the diagnosis of thyroid nodules between US and VTQ.Results Under the golden standard determined according to the pathological examination, the sensitivity, specificity and accuracy of the diagnosis of thyroid nodules by UC were 80.4% (41/51), 81.4%(35/43) and 80.9% (76/94) respectively.Malignant thyroid nodules were higher than benign thyroid nodules in SWV〔(3.29 ±1.20) m/s vs.(1.98 ±0.45) m/s〕 (t =-6.813, P <0.001) .With SWV =2.75 m/s as the cutoff value, the sensitivity, specificity and accuracy of the diagnosis of thyroid nodules by VTQ were 92.2% (47/51), 88.4% (38/43) and 90.4% (85/94) .The area under ROC curve was 0.804 for US and 0.918 for VTQ in the diagnosis of malignant thyroid nodules, with a significant difference between them (Z=5.576, P<0.001) .Conclusion US and VTQ are all helpful in differentiating malignant and benign thyroid nodules, while VTQ is obvious superior to US.
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