常规超声及实时弹性成像和声脉冲辐射力弹性成像鉴别甲状腺结节良恶性的临床诊断试验

发布时间：2018-05-02 21:51

本文选题：甲状腺结节 + 超声检查　；参考：《中国全科医学》2015年06期

【摘要】：目的探讨常规超声(US)、实时弹性成像(UE)及声脉冲辐射力弹性成像(ARFI)在甲状腺结节良恶性鉴别诊断中的应用价值。方法选取2012年8月—2014年3月在石河子大学医学院第一附属医院行甲状腺切除术的96例患者(100个甲状腺结节)。US采用半定量评分方法判断结节性质,UE采用5级评分法判断结节性质,ARFI定量测定结节内剪切波速度(SWV),以病理检查为金标准,计算灵敏度、特异度、正确率,比较US、UE、SWV的ROC曲线下面积,判定诊断效能。结果 US诊断甲状腺结节良恶性的灵敏度、特异度、正确率分别为:73.9%(17/23)、80.5%(62/77)、79.0%(79/100);UE诊断甲状腺结节良恶性的灵敏度、特异度、正确率分别为:87.0%(20/23)、75.3%(58/77)、78.0%(78/100);ARFI诊断甲状腺结节良恶性灵敏度、特异度、正确率分别为91.3%(21/23)、85.7%(66/77)、87.0%(87/100)。77个良性甲状腺结节SWV值为(2.22±0.49)m/s,23个恶性甲状腺结节SWV值为(3.39±1.28)m/s,恶性甲状腺结节SWV值高于良性甲状腺结节(t=6.74,P0.001)。US、UE、SWV诊断甲状腺结节良恶性的ROC曲线下面积分别为0.776、0.800、0.923,差异有统计学意义(Z=44.062,P0.01);其中UE、SWV大于US,SWV大于UE(P0.05)。结论 US、UE及ARFI均有助于鉴别诊断甲状腺结节良恶性,UE优于US,ARFI优于UE及US。
[Abstract]:Objective to evaluate the value of conventional ultrasound, real time elastic imaging (UEE) and acoustic pulse power elastography (ARFI) in the differential diagnosis of benign and malignant thyroid nodules. Methods from August 2012 to March 2014, 96 patients underwent thyroidectomy in the first affiliated Hospital of Shihezi University School of Medicine (100 thyroid nodule. Us used semi-quantitative evaluation method to judge the nodular nature of UE with grade 5 score). Methods to determine the nature of nodules by ARFI and determine the shear wave velocities in the nodules with SWVV. Pathological examination was regarded as the gold standard. The sensitivity, specificity and accuracy were calculated. The area under the ROC curve of USUE SWV was compared to determine the diagnostic effectiveness. Results the sensitivity, specificity and accuracy of US in the diagnosis of benign and malignant thyroid nodules were: 73.9and 17 / 23 / 80.5 / 79.079 / 100UE, respectively. The sensitivity, specificity and accuracy of US in the diagnosis of benign and malignant thyroid nodules were as follows: 87.0 / 20 / 2375.35.35.35.35.35 / 78.0 / 78.00 / 78100% ARFI, respectively, in the diagnosis of benign and malignant thyroid nodules, the sensitivity, specificity and accuracy of US in the diagnosis of benign and malignant thyroid nodules were as follows: The correct rates were 91.33% 21 / 23% 85.70.77% 87 / 100%. The SWV value of 77 benign thyroid nodules was 2.22 卤0.49 m / s, and the SWV value of 23 malignant thyroid nodules was 3.39 卤1.28 m / s. The SWV value of malignant thyroid nodules was higher than that of benign thyroid nodules (6.74% P0.001N. USUESWV). The area under the ROC curve for the diagnosis of benign and malignant thyroid nodules was as follows: The difference was statistically significant (P 0.01), and the SWV of UEN was greater than that of USV (P 0.05). Conclusion UE and ARFI are helpful in differential diagnosis of benign and malignant thyroid nodules.
【作者单位】：石河子大学医学院第一附属医院功能科;石河子大学医学院预防医学系;
【分类号】：R736.1;R445.1

【参考文献】