2015ATA超声指南、超微血管成像技术和频谱多普勒在甲状腺结节良恶性鉴别中的应用价值

发布时间：2019-02-08 19:29

【摘要】：目的:探讨2015ATA指南超声模式、彩色多普勒(CDFI)、超微血管成像技术(SMI)和频谱多普勒诊断良恶性甲状腺结节的价值。方法:收集经超声检出并经细针穿刺细胞学(FNAC)或病理学证实的254个甲状腺结节作为研究对象,对每个结节分别行二维超声、CDFI、SMI和频谱多普勒检查,参考Kim甲状腺结节血流分布模式的标准,分别观察同一病灶在不同技术所显示的血流分布情况。使用受试者工作特征曲线(ROC)计算得出RI、PI鉴别甲状腺结节良恶性的最佳诊断界点。结果:(1)SMI对良性甲状腺结节的周边型以及恶性甲状腺结节中央型血流分布模式更敏感,且差异有统计学意义(P0.05);(2)RI、PI对鉴别甲状腺结节的良恶性有统计学意义(P0.05);(3)2015ATA+SMI联合诊断模式的特异性和敏感性明显高于其他单一诊断模式,且差异有统计学意义;(4)2015ATA+SMI+频谱多普勒联合诊断模式和2015ATA+SMI联合诊断模式对比,敏感性、特异性和准确性均有所提高,但三者的差异无统计学意义。结论:SMI血流检出率更高,在甲状腺结节的良恶性鉴别诊断中有一定的应用价值。2015ATA+SMI联合诊断模式能够提高超声对甲状腺良恶性结节的诊断效能。
[Abstract]:Objective: to evaluate the value of 2015ATA guided ultrasound mode, color Doppler (CDFI), supermicrovessel imaging (SMI) and spectrum Doppler imaging in the diagnosis of benign and malignant thyroid nodules. Methods: 254 thyroid nodules, which were detected by ultrasound and confirmed by fine needle aspiration cytology (FNAC) or pathology, were examined by two-dimensional ultrasound, CDFI,SMI and spectral Doppler respectively. According to the standard of Kim thyroid nodule blood flow distribution, the blood flow distribution of the same lesion was observed by different techniques. The optimal diagnostic threshold of RI,PI for differentiating benign and malignant thyroid nodules was calculated by using the operating characteristic curve (ROC) of the subjects. Results: (1) SMI was more sensitive to the distribution pattern of peripheral and central blood flow in benign thyroid nodules and malignant thyroid nodules, and the difference was statistically significant (P0.05). (2) the specificity and sensitivity of RI,PI in differentiating benign and malignant thyroid nodules (P0.05); (3) were significantly higher than those in other single diagnostic models (P0.05); (3). (4) the sensitivity, specificity and accuracy of 2015ATA SMI spectrum Doppler combined diagnosis mode and 2015ATA SMI combined diagnostic mode were improved, but there was no significant difference among them. Conclusion: the detection rate of SMI blood flow is higher and it has certain value in the differential diagnosis of benign and malignant thyroid nodules. The combined diagnostic mode of 2015ATA SMI can improve the diagnostic efficacy of ultrasound for benign and malignant thyroid nodules.
【作者单位】：河北北方学院;河北北方学院附属第一医院超声医学科;河北北方学院附属第一医院耳鼻咽喉头颈外科;
【分类号】：R581;R736.1

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