TI-RADS分级联合超声弹性成像诊断甲状腺微小乳头状癌价值研究

发布时间：2018-02-03 14:37

  本文关键词： 甲状腺影像学报告及数据系统 超声弹性成像 甲状腺微小乳头状癌 术前诊断　出处：《中国实用外科杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨甲状腺影像学报告及数据系统(TI-RADS)分级联合超声弹性成像(UE)在甲状腺微小乳头状癌(PTMC)术前诊断中的临床价值。方法回顾性分析2013年6月至2015年6月甘肃省肿瘤医院行超声检查的96例(138个恶性结节)PTMC病人和78例(142个微小良性结节)甲状腺病病人的临床资料。以病理学检查结果为金标准,比较TI-RADS分级、UE及两者联合诊断PTMC的敏感度、特异度、阳性预测值、阴性预测值及准确率。计算三种方法诊断PTMC的受试者工作特性(ROC)曲线下面积。根据结节直径将PTMC病人分为5 mm组和≤5 mm组,比较各诊断方法的准确率。结果 TI-RADS分级联合UE诊断PTMC的敏感度、特异度、阳性预测值、阴性预测值及诊断准确率(93.5%、97.2%、97.0%、93.9%及95.4%)均高于UE(87.7%、93.7%、93.1%、88.7%及90.7%)和TI-RADS分级(80.4%、87.3%、86.0%、82.1%及83.9%)。TI-RADS分级、UE及二者联合诊断PTMC的ROC曲线下面积分别为0.873、0.937、0.972,UE的诊断价值高于TI-RADS分级(P0.05),两种方法联合诊断价值高于单一方法(P0.05)。三种方法对≤5 mm和5 mm PTMC的诊断准确率分别为72.8%、90.1%、92.7%和89.9%、92.3%、97.2%,UE对于≤5 mm PTMC的诊断准确率明显高于TI-RADS分级(P0.05)。结论 UE对PTMC的术前诊断价值高于TI-RADS分级,尤其对于≤5 mm的PTMC诊断准确率更高,二者联合有助于提高PTMC术前诊断准确率。
[Abstract]:Objective to investigate the application of TI-RADS classification combined with ultrasound elastography (UEE) in PTMC of thyroid micropapillary carcinoma. Methods from June 2013 to June 2015, 96 patients (138 malignant nodule PTMC) and 78 patients with PTMC underwent ultrasound examination in Gansu Provincial Cancer Hospital were retrospectively analyzed. Clinical data of 142 patients with thyroid disease. To compare the sensitivity, specificity and positive predictive value of TI-RADS grade UE and their combination in the diagnosis of PTMC. The negative predictive value and accuracy were calculated. The area under the curve was calculated for the three methods to diagnose PTMC. According to the diameter of nodules, the patients with PTMC were divided into 5 mm group and 鈮，

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