实时剪切波弹性成像技术对甲状腺TI？？RADS 4级结节的诊断价值*
Diagnostic value of real？？time shear wave elastography for TI？？RADS grade 4 thyroid nodules

目的：探讨实时剪切波弹性成像（SWE）技术对TI？？RADS 4级甲状腺单发实性结节良恶性判定的应用价值。方法：对132例TI？？RADS 4级甲状腺单发实性结节患者行SWE检查，获取病灶杨氏模量平均值（Emean），以病理结果为金标准绘制ROC曲线，得出最佳界值。将4a级结节中Emean低于界值者判定为3级，将4b级结节中Emean高于界值者判定为5级；余保持不变。分析调整前后的诊断结果。结果：常规超声检查判定为4a级结节73例，根据SWE，51例被判定为3级结节，其中良性46例，恶性5例；常规超声检查判定为4b级结节59例，根据SWE，42例被判定为5级结节，其中良性4例，恶性38例。结论：对于TI？？RADS 4级结节行SWE检查可以进一步判定良、恶性，有效降低穿刺活检率。
To evaluate the diagnostic value of real？？time shear wave elastography(SWE) for thyroid single solid nodule.Methods: SWE was performed on 132 patients with thyroid nodules of TI？？RADS grade 4 and the mean Young's modulus(Emean) was obtained. With the pathological results as gold standard, ROC curve was drawn to obtain the threshold value. By comparing Emean with the threshold value,grade 4a nodules with Emean lower than the threshold value was defined as grade 3 nodules,grade 4b nodules with Emean higher than the threshold value was defined as grade 5 nodules,and other factors remained unchanged. Diagnostic results were analyzed before and after modulation.Results: In 73 cases of grade 4a nodules, 51 cases were diagnoses as grade 3 according to SWE, out of which 46 were benign and 5 were malignant. In 59 cases of grade 4b nodules, 42 cases were diagnoses as grade 5 according to SWE, out of which 4 cases were benign and 38 cases were malignant.Conclusion: SWE can decrease the biopsy rate of TI？？RADS grade 4 thyroid nodules diagnosed by conventional ultrasound by discriminating the benign and malignant nodules