弹性成像与常规超声联合评分鉴别甲状腺良恶性结节的诊断价值

发布时间：2018-04-02 14:25

  本文选题：甲状腺影像报告与评分系统　切入点：弹性成像　出处：《医学研究生学报》2015年10期

【摘要】：目的高频超声的广泛应用使得甲状腺结节的检出率逐年增加。文中旨在探讨常规超声、弹性成像及两者联合应用对甲状腺良恶性结节的诊断价值。方法回顾性分析南京军区南京总医院2014年9月至2015年8月105例甲状腺结节患者的160枚甲状腺结节超声图像,通过绘制甲状腺影像报告与评分系统(thyroid imaging reporting and data system,TI-RADS)评分、弹性评分和联合评分ROC曲线,计算并比较曲线下面积,选取合适截断点,分别计算3种方法的诊断效能,并与病理结果进行Kappa一致性检验。结果联合评分的ROC曲线的曲线下面积(0.930,95%CI:0.890~0.969)大于TI-RADS评分(0.855,95%CI:0.794~0.915)和弹性评分(0.845,95%CI:0.780~0.909),差异均有统计学意义(P0.05)。以TI-RADS≥4分,弹性评分≥3分及联合评分≥7分为诊断甲状腺恶性结节的界点,联合评分的特异度、阳性预测值(94.3%、91.7%)均高于TI-RDAS评分(78.4%、84.7%)和弹性评分(81.8%、78.7%)。联合评分的敏感度低于弹性评分和TI-RDAS评分,而其NPV高于TI-RDAS评分,低于弹性评分。联合评分的Kappa值(0.718,95%CI:0.610~0.826)均高于TIRDAS评分(0.586,95%CI:0.461~0.711)和弹性评分(0.635,95%CI:0.515~0.755)。结论常规超声与弹性成像相互补充,联合评分较单一检查方法具有更高的诊断价值。
[Abstract]:Objective the detection rate of thyroid nodules increases year by year with the wide use of high frequency ultrasound.The purpose of this paper is to evaluate the diagnostic value of conventional ultrasound, elastic imaging and combined use of both in benign and malignant thyroid nodules.Methods 160 thyroid nodules from 105 patients with thyroid nodules in Nanjing General Hospital of Nanjing military region from September 2014 to August 2015 were analyzed retrospectively. Thyroid imaging reporting and data system TI-RADSs were evaluated by drawing the thyroid imaging report and scoring system.The area under the curve was calculated and compared, the suitable truncation point was selected, the diagnostic efficacy of the three methods was calculated, and the consistency test of Kappa with pathological results was carried out.Results the area under the curve of the joint score ROC curve was 0.930 / 95 CI: 0.890 / 0.969) which was larger than that of the TI-RADS score of 0.85595% 0.794 / 0.915) and the elastic score of 0.84595% was 0.909%. The difference was statistically significant (P 0.05).TI-RADS 鈮，

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