超声弹性比值法鉴别诊断甲状腺实性结节及诊断一致性

发布时间：2018-10-25 07:48

【摘要】：目的探讨实时超声弹性成像比值法鉴别诊断甲状腺实性结节良恶性的价值及不同医师之间的一致性。方法由2名有经验的医生对72例共89个甲状腺实性结节进行超声弹性成像检查,测定结节与周围腺体的弹性指数比值,绘制ROC曲线并确定鉴别甲状腺实性结节良恶性的最佳诊断临界点,以病理结果为金标准,计算敏感度、特异度、准确率、阳性及阴性预测值。分析2名医师诊断的一致性。结果 2名医师应用ROC曲线获得最佳诊断临界点均为3.40。将弹性指数比值≥3.40诊断为恶性,医师1鉴别诊断甲状腺实性结节良恶性的敏感度、特异度、准确率、阳性及阴性预测值分别为90.24%(37/41)、85.42%(41/48)、87.64%(78/89)、84.09%(37/44)、91.11%(41/45);医师2分别为90.24%(37/41)、83.33%(40/48)、86.52%(77/89)、82.22%(37/45)、90.91%(40/44)。两名医师弹性诊断一致率为96.63%(86/89),ICC值为0.98。结论超声弹性成像比值法为甲状腺实性结节良恶性的鉴别诊断提供了定量诊断指标,具有较好的应用价值,不同医师独立完成弹性成像的定量指数比值具有良好的一致性。
[Abstract]:Objective to investigate the value of real-time ultrasound elastography in differential diagnosis of benign and malignant solid thyroid nodules and the consistency between different physicians. Methods Elastography was performed on 72 solid thyroid nodules in 72 cases by two experienced doctors. The ratio of elastic index of nodules to surrounding glands was measured. ROC curve was drawn and the best diagnostic critical point for differentiating benign and malignant solid thyroid nodules was determined. The sensitivity specificity accuracy positive and negative predictive values were calculated by using pathological results as gold standard. The diagnostic consistency of 2 physicians was analyzed. Results the critical point of the two physicians using ROC curve to obtain the best diagnosis was 3.40. The sensitivity, specificity, accuracy, positive and negative predictive values for differential diagnosis of benign and malignant solid thyroid nodules were 90.24% (37 / 41), 85.42% (41 / 48), 87.64% (78 / 89), 84.09% (37 / 44), 91.11% (41 / 45), 90.24% (37 / 41), 83.33% (40 / 48), 86.52% (77 / 89), 82.22% (3745), 91.11% (41 / 45), 90.24% (37 / 41), 83.33% (40 / 48), 86.52% (77 / 89), 82.22% (3745), 90.91% (4044 / 45), respectively. The consistent rate of elastic diagnosis between the two physicians was 96.63% (86 / 89), ICC = 0.98). Conclusion the ultrasonic elastic imaging ratio method provides a quantitative diagnostic index for the differential diagnosis of benign and malignant solid thyroid nodules, and has a good application value. The quantitative index ratio of different physicians independently completing elastic imaging has good consistency.
【作者单位】：山西医科大学第一医院超声科;
【基金】：山西省回国留学人员科研资助项目(2014-073) 山西省高校131领军人才工程优秀拔尖人才支持基金(2013-404)
【分类号】：R445.1;R736.1

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