VTQ技术联合TI-RADS对甲状腺结节良恶性的鉴别诊断价值

发布时间：2017-12-31 21:37

本文关键词：VTQ技术联合TI-RADS对甲状腺结节良恶性的鉴别诊断价值　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨甲状腺声触诊组织量化技术、影像报告和数据系统以及二者结合对甲状腺结节良恶性的鉴别诊断,以期寻找对甲状腺结节进行定性定量的新线索。方法:对2015年12月-2016年12月经术后病理证实的108例病例共142个结节行二维灰阶超声波检查,并参照TI-RADS标准,2、3级划分为良性结节,4、5级划分为恶性结节,采用ARFI技术的VTQ软件检测结节内的剪切波速度(单位:m/s)。二者联合应用时,VTQ技术诊断为良性结节,TI-RADS分级减一级,VTQ技术诊断为恶性结节时,TI-RADS分级加一级,以新TI-RADS2、3级诊断为良性,新TI-RADS 4、5级为恶性(原分级为2、5级仍以原分级计)。以术后病理结果为金标准,计算TI-RADS标准、VTQ技术及VTQ技术+TI-RADS标准结合诊断恶性结节的准确率、敏感度、特异度,构建ROC曲线进行分析。结果:共计142个结节,恶性55个,良性87个。VTQ技术判定恶性53个,良性89个,TI-RADS判定恶性46个,良性96个,VTQ技术+TI-RADS判定恶性57个,良性85个。VTQ技术检查结果的准确度为88.02%(125/142),敏感度83.33%(45/54),特异度90.90%(80/88),阳性预测值84.90%(45/53),阴性预测值89.88%(80/89),95%CI(0.743,0.907),约登指数0.74。TI-RADS检查结果的准确度为83.80%(119/142),敏感度70.90%(39/55),特异度91.95%(80/87),阳性预测值84.78%(39/46),阴性预测值83.33%(80/96),95%CI(0.755,0.903),约登指数0.62。VTQ技术+TI-RADS检查结果的准确度为88.02%(125/142),敏感度89.09%(49/55),特异度87.35%(76/87),阳性预测值81.66%(49/60),阴性预测值92.68%(76/82),95%CI(0.896,0.981),约登指数0.82。VTQ技术、TI-RADS及二者结合应用定性恶性结节的ROC曲线下面积为0.825、0.828、0.939。结论:VTQ技术可反应甲状腺结节的弹性模量,对甲状腺结节良恶性的鉴别具有肯定的作用,VTQ技术与常规超声TI-RADS标准对甲状腺结节的性质判定各有优势,二者结合检查可提升甲状腺结节性质的辨别效力。
[Abstract]:Objective: To investigate the thyroid vtq, imaging reporting and data system and the combination of the two in the differential diagnosis of benign and malignant thyroid nodules, in order to find a new line of qualitative and quantitative to thyroid nodules cable. Methods: 108 cases of -2016 year in December 2015 12 menstrual postoperative pathology confirmed a total of 142 nodules underwent two-dimensional gray scale ultrasound, and according to TI-RADS standard, 2,3 was divided into 4,5 grade divided into benign nodules, malignant nodules, nodule detection of shear wave velocity VTQ software using ARFI technology in the (unit: m/s). The combination of the two methods, the VTQ technique in the diagnosis of benign nodules, TI-RADS grade reduction level, VTQ diagnosis malignant nodules, TI-RADS grade and level, with new TI-RADS2,3 diagnosed as benign, malignant grade 4,5 for the new TI-RADS (the original grade 2,5 is still the original classification. Plan) to the postoperative pathological results as the gold standard, calculation of TI-RADS Standard, VTQ technology and VTQ technology combined with +TI-RADS standard for the diagnosis of malignant nodules. The accuracy, sensitivity, specificity, construct ROC curve were analyzed. Results: a total of 142 malignant nodules and 55 benign, 87.VTQ technique to determine the 53 malignant, 89 benign, 46 malignant TI-RADS criteria, 96 benign. VTQ +TI-RADS determination of 57 malignant and 85 benign.VTQ examination results accuracy is 88.02% (125/142), the sensitivity was 83.33%, specificity 90.90% (45/54) (80/88), the positive predictive value of 84.90% (45/53), and negative predictive value of 89.88% (80/89), 95%CI (0.743,0.907), the Jorden index of 0.74.TI-RADS examination results the accuracy was 83.80% (119/142), the sensitivity was 70.90%, specificity 91.95% (39/55) (80/87), the positive predictive value of 84.78% (39/46), and negative predictive value of 83.33% (80/96), 95%CI (0.755,0.903), Youden index 0.62.VTQ +TI-RADS examination results accuracy is 88.02% (125/142), sensitive 89.09% (49/55), specificity 87.35%, positive predictive value (76/87) 81.66% (49/60), and negative predictive value of 92.68% (76/82), 95%CI (0.896,0.981), the Jorden index 0.82.VTQ, ROC curve area TI-RADS and the combination of the two qualitative malignant nodules was 0.825,0.828,0.939. conclusion: VTQ technology can response the elastic modulus of thyroid nodules, has a positive effect on the differentiation of benign and malignant thyroid nodules, properties of VTQ and conventional ultrasound TI-RADS standard for thyroid nodules to determine the different advantages, the combination of the two examinations can improve thyroid nodules identification effect.

【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R581

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