声速匹配技术在甲状腺疾病诊断中的应用价值
发布时间：2018-12-19 07:11
【摘要】：目的通过声速匹配技术测定甲状腺疾病的声速匹配值，探讨其在甲状腺疾病诊断及鉴别诊断中的应用价值及其测定过程中的影响因素。 方法1选取原发性甲亢(graves)患者34例，桥本氏甲状腺炎(Hashimoto'sthyroiditis,HT)患者41例，正常对照组52例；二维彩超常规观察甲状腺大小、实质、血流，并测量甲状腺被膜距体表厚度；启动声速匹配技术测量甲状腺呼吸前、后声速匹配值（zone speed index，ZSI）各6次，分别计算屏住呼吸前、后ZSI的ICC（组内相关系数），并计算屏住呼吸后ZSI的平均值，从而得出该区域的声速（The speed of sound，SV）为（1540+ZSI）m/s。对两组患者的ZSI值进行分析，用组内相关系数（ICC)预测其稳定性。2选取经手术病理证实的65例患者的77个甲状腺结节，其中良性结节51个（结节性甲状腺肿38个，腺瘤13个），恶性结节26个(乳头状癌20个，滤泡状癌4个，未分化癌1个，梭形巨细胞瘤1个)，二维常规观察甲状腺结节大小、回声、血流、边界、钙化、囊变，并测量结节的大小及结节上缘距体表的距离，启动声速匹配技术，测量77个结节的声速匹配值，以病理结果作为金标准，构建ROC曲线，判断声速匹配技术对甲状腺良恶性结节的诊断价值，并分析结节的深度与ZSI的关系。 结果1HT组的SV高于正常组及Graves组，Graves组的SV低于正常组，三者比较两两之间差异均有统计学意义（P 0.05）；声速匹配技术测定甲状腺疾病的声速匹配值具有很好的稳定性（ICC0.90），但受呼吸影响大；甲状腺被膜距体表厚度与ZSI无相关性。2甲状腺良性结节的ZSI值低于恶性结节，差异有统计学意义（P 0.05）。ROC曲线下面积0.91，ZSI判断良、恶性结节的最佳临界点为39.17m/s，以此为界点ZSI判别甲状腺恶性结节的敏感性、特异性分别为92%、85%。甲状腺结节的深度与ZSI无显著相关性（良性结节r=0.05，P=0.72，恶性结节r=0.04，P=0.83）。 结论1声速匹配技术作为一项新技术，测甲状腺声速时，屏住呼吸后ICC0.90，说明屏住呼吸后声速匹配技术具有很好的稳定性。2桥本氏甲状腺炎的声速高于原发性甲亢及正常对照组，原发性甲亢的声速匹配值低于正常对照组；恶性结节的声速高于良性结节，通过构建良、恶性结节的ROC曲线得出声速匹配技术判断甲状腺良、恶性结节的最佳临界点为39.17cm/s，，敏感性、特异性分别为92%、85%。声速匹配技术可以为诊断及鉴别诊断甲状腺疾病提供客观参考依据。3声速匹配技术测甲状腺疾病声速时与超声声波所经甲状腺疾病前方组织无相关性。
[Abstract]:Objective to study the value of ultrasonic velocity matching in the diagnosis and differential diagnosis of thyroid diseases and its influencing factors. Methods 1Thirty-four patients with primary hyperthyroidism (graves), 41 patients with Hashimoto's thyroiditis (Hashimoto'sthyroiditis,HT) and 52 normal controls were selected. The size, parenchyma and blood flow of thyroid gland were observed by two-dimensional color Doppler ultrasound, and the thickness of thyroid capsule from body surface was measured. The ICC (intra-group correlation coefficient) of ZSI before and after holding the breath was calculated, and the mean value of ZSI after holding the breath was calculated. The sound velocity (The speed of sound,SV of the region is (1540 ZSI) m / s. The ZSI values of the two groups were analyzed, and the stability of the patients was predicted by intra-group correlation coefficient (ICC). 2Seventy-seven thyroid nodules were selected from 65 patients confirmed by surgery and pathology, including 51 benign nodule (38 nodular goiter). 13 adenomas, 26 malignant nodules (20 papillary carcinomas, 4 follicular carcinomas, 1 undifferentiated carcinoma, 1 spindle giant cell tumor). The size of the nodules and the distance from the upper edge of the nodules to the body surface were measured. The sound velocity matching values of 77 nodules were measured by starting the sound velocity matching technique. The ROC curves were constructed according to the pathological results as the gold standard. To evaluate the diagnostic value of ultrasonic velocity matching technique in benign and malignant thyroid nodules, and to analyze the relationship between the depth of thyroid nodules and ZSI. Results the SV of 1HT group was higher than that of normal group and Graves group, and the SV of Graves group was lower than that of normal group. The sound velocity matching value of thyroid disease measured by sound velocity matching technique has good stability (ICC0.90), but it is greatly affected by respiration. The ZSI value of benign thyroid nodules was lower than that of malignant nodules, and the difference was statistically significant (P < 0. 05). ROC curve). The best critical point for malignant nodules was 39.17 m / s, and the sensitivity of ZSI as a boundary point for the diagnosis of malignant thyroid nodules was 92% and 85%, respectively. There was no significant correlation between the depth of thyroid nodule and ZSI (benign nodule was 0. 05% P0. 72, malignant nodule was 0. 04% P0. 83). Conclusion (1) as a new technique, the supersonic velocity matching technique is a new technique for measuring thyroid sound velocity, ICC0.90, after holding one's breath. 2 the sound velocity of Hashimoto's thyroiditis was higher than that of primary hyperthyroidism and normal control group, and the matching value of acoustic velocity of primary hyperthyroidism was lower than that of normal control group. The sound velocity of malignant nodules was higher than that of benign ones. The ROC curves of benign and malignant nodules were constructed to determine the benign thyroid gland. The optimal critical point for malignant nodules was 39.17 cm / s, with sensitivity and specificity of 92 ~ 85 cm / s, respectively. Sonic velocity matching technique can provide an objective reference for diagnosis and differential diagnosis of thyroid diseases. 3 there is no correlation between ultrasonic velocity matching technique and anterior tissue of thyroid disease.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581;R445.1
本文编号：2386581
[Abstract]:Objective to study the value of ultrasonic velocity matching in the diagnosis and differential diagnosis of thyroid diseases and its influencing factors. Methods 1Thirty-four patients with primary hyperthyroidism (graves), 41 patients with Hashimoto's thyroiditis (Hashimoto'sthyroiditis,HT) and 52 normal controls were selected. The size, parenchyma and blood flow of thyroid gland were observed by two-dimensional color Doppler ultrasound, and the thickness of thyroid capsule from body surface was measured. The ICC (intra-group correlation coefficient) of ZSI before and after holding the breath was calculated, and the mean value of ZSI after holding the breath was calculated. The sound velocity (The speed of sound,SV of the region is (1540 ZSI) m / s. The ZSI values of the two groups were analyzed, and the stability of the patients was predicted by intra-group correlation coefficient (ICC). 2Seventy-seven thyroid nodules were selected from 65 patients confirmed by surgery and pathology, including 51 benign nodule (38 nodular goiter). 13 adenomas, 26 malignant nodules (20 papillary carcinomas, 4 follicular carcinomas, 1 undifferentiated carcinoma, 1 spindle giant cell tumor). The size of the nodules and the distance from the upper edge of the nodules to the body surface were measured. The sound velocity matching values of 77 nodules were measured by starting the sound velocity matching technique. The ROC curves were constructed according to the pathological results as the gold standard. To evaluate the diagnostic value of ultrasonic velocity matching technique in benign and malignant thyroid nodules, and to analyze the relationship between the depth of thyroid nodules and ZSI. Results the SV of 1HT group was higher than that of normal group and Graves group, and the SV of Graves group was lower than that of normal group. The sound velocity matching value of thyroid disease measured by sound velocity matching technique has good stability (ICC0.90), but it is greatly affected by respiration. The ZSI value of benign thyroid nodules was lower than that of malignant nodules, and the difference was statistically significant (P < 0. 05). ROC curve). The best critical point for malignant nodules was 39.17 m / s, and the sensitivity of ZSI as a boundary point for the diagnosis of malignant thyroid nodules was 92% and 85%, respectively. There was no significant correlation between the depth of thyroid nodule and ZSI (benign nodule was 0. 05% P0. 72, malignant nodule was 0. 04% P0. 83). Conclusion (1) as a new technique, the supersonic velocity matching technique is a new technique for measuring thyroid sound velocity, ICC0.90, after holding one's breath. 2 the sound velocity of Hashimoto's thyroiditis was higher than that of primary hyperthyroidism and normal control group, and the matching value of acoustic velocity of primary hyperthyroidism was lower than that of normal control group. The sound velocity of malignant nodules was higher than that of benign ones. The ROC curves of benign and malignant nodules were constructed to determine the benign thyroid gland. The optimal critical point for malignant nodules was 39.17 cm / s, with sensitivity and specificity of 92 ~ 85 cm / s, respectively. Sonic velocity matching technique can provide an objective reference for diagnosis and differential diagnosis of thyroid diseases. 3 there is no correlation between ultrasonic velocity matching technique and anterior tissue of thyroid disease.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581;R445.1
【参考文献】
相关期刊论文 前2条
1 王静;;彩超检查甲状腺疾病124例诊断分析[J];中国医药指南;2011年03期
2 吴茂英;;彩超观测甲状腺上动脉内径及血流峰值变化对甲亢的疗效评估[J];中国医药指南;2012年30期
本文编号：2386581
本文链接：https://www.wllwen.com/yixuelunwen/fangshe/2386581.html
