三维容积成像在甲状腺实性结节诊断中的应用

发布时间：2018-10-24 16:36

【摘要】：目的探讨三维容积成像在甲状腺实性结节良恶性鉴别中的应用价值。方法对119例甲状腺实性结节手术患者共144个结节行二维及三维超声检查,利用三维容积及断层技术行三维重建,分析良恶性结节的冠状面成像特征,评价其诊断价值。结果 144个结节中,良性结节75例,恶性结节69例。冠状面成像特征中,良恶性结节的形态、边界、边缘有无成角或毛刺、内部回声及有无微钙化差异均有统计学意义(P均0.05)。建立Logistic回归模型,最终进入模型的甲状腺恶性结节冠状面成像特征包括形态不规则、边缘成角或毛刺、低回声。三维超声诊断甲状腺恶性实性结节的敏感度为92.75%(64/69),特异度为85.33%(64/75),准确率为88.89%(128/144),均高于二维超声[89.86%(62/69),80.00%(60/75),84.72%(122/144)],但两者的诊断效能差异均无统计学意义(P均0.05)。结论在三维冠状面成像中,甲状腺良恶性结节的特征差异显著。三维容积成像在甲状腺实性结节的良恶性鉴别诊断中具有重要的价值。
[Abstract]:Objective to evaluate the value of three-dimensional volumetric imaging in differentiating benign and malignant solid thyroid nodules. Methods one hundred and forty-four solid thyroid nodules were examined by two-dimensional and three-dimensional ultrasonography. The features of coronal imaging of benign and malignant nodules were analyzed and the diagnostic value was evaluated. Results among 144 nodules, 75 were benign nodules and 69 were malignant nodules. In coronal imaging, there were significant differences in the shape, boundary and edge of benign and malignant nodules with or without angle or burr, internal echo and microcalcification (P 0.05). The Logistic regression model was established, and the coronal imaging features of thyroid malignant nodules were irregular, edge-angled or burr, and hypoechoic. The sensitivity, specificity and accuracy of three-dimensional ultrasonography in the diagnosis of thyroid malignant solid nodules were 92.75% (64 / 69), 85.33% (64 / 75) and 88.89% (128 / 144), respectively, which were higher than those of two-dimensional ultrasound [89.86% (62 / 69), 80.00% (60 / 75), 84.72% (122 / 144)], but there was no significant difference between them (P 0.05). Conclusion the characteristics of benign and malignant thyroid nodules are significantly different in three-dimensional coronal imaging. Three-dimensional volumetric imaging plays an important role in the differential diagnosis of thyroid solid nodules.
【作者单位】：河北医科大学第四医院超声科;
【基金】：河北省自然科学基金(H2015206405) 河北省高校强势特色学科——第四医院肿瘤学支持项目(冀教高[2005]52号)
【分类号】：R736.1;R445.1

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