超声新技术在甲状腺微小乳头状癌中的应用价值

发布时间：2017-12-28 00:35

本文关键词：超声新技术在甲状腺微小乳头状癌中的应用价值　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:对比研究PTMC在超声新技术(CEUS和UE)的相关声像学特点,总结两种技术方法对PTMC的鉴别诊断作用和临床应用价值。方法:从重庆医科大学第一附属医院内分泌乳腺外科病案室及电子病历系统调取2015年6月~2016年2月期间收治的全部PTMC患者69例(肿瘤直径≤10mm),共107个结节,全部病例均经病理活检证实且完整收集病案资料(包括甲状腺超声图像和病理报告)。我院病案室调阅收集、电话咨询患者本人、电子病历系统查阅等方式整理病历资料,收集分析运用超声新技术所获图像信息,按照患者身份信息、肿瘤特点、超声新技术(CEUS和UE)声像特点、术后病检等资料完成横向分析总结。所有数据皆以SPSS 18.0软件进行统计学分析处理;计数资料皆采用X2检验,当P0.05时,认为差异具有统计学意义;根据超声新技术(CEUS和UE)的成像特点进行数据整理分析,并比较相关重要参数资料分别在甲状腺良恶性微小结节中的特点。通过与术后病检结果比对,遴选出差异显著的指标,采用统计学原理分别计算其诊断效能等相关指标,比较相关主要参数对PTMC的诊断价值。结果:经超声新技术检查拟诊并经术后病理检查结果证实的69例PTMC(共107个结节)患者中,有75个甲状腺微小结节被证实为恶性,病理报告为PTMC;另外有甲状腺良性微小结节32个,其中26个为NG,3个为微小乳头状瘤,另有1个为血凝块机化和1例增生病变伴有钙化。经统计学分析处理后显示:结节是否均匀增强、增强强度、是否早期消退、是否有规则的边缘增强、超声弹性成像评分等情况在甲状腺微小良恶性结节中的检出情况呈现出显著的差异(P0.05)(见表1)。CEUS和UE诊断PTMC的敏感性和特异性分别为84.00%、68.75%和93.33%、90.63%;CEUS与UE二者联合,其诊断敏感性和特异性可达96.00%和96.88%,相对于两种检查分别独立应用时明显提高。结论:(1)CEUS以及UE对于PTMC的诊断均具有可靠实用价值,UE较CEUS具有更高的诊断效能。(2)联合应用CEUS及UE,可提高对PTMC的诊断敏感性和准确性。
[Abstract]:Objective: To compare the sonographic characteristics of PTMC in the new ultrasonic technology (CEUS and UE), and to summarize the two diagnostic methods for PTMC and its clinical application value. Methods: 69 cases admitted during the period from the endocrine breast surgery department of the First Affiliated Hospital of Medical University Of Chongqing medical records and electronic medical records system from June 2015 February ~2016 all PTMC patients (tumor diameter less than 10mm), a total of 107 nodules, all cases were confirmed by pathological biopsy and complete collection of medical records (including thyroid ultrasound image and pathology report). The Department of medical records collection, access to telephone counseling patients, the electronic medical record system to organize medical records, collect and analyze the information received by the image of new ultrasound technology, according to the new technology with the identity information, tumor characteristics, ultrasound (CEUS and UE) the diagnosis and postoperative pathological data of complete transverse analysis summary. All the data with SPSS 18 software for statistical analysis and processing; count data using X2 test, when P0.05, that the difference was statistically significant; according to the new ultrasound technology (CEUS and UE) data were collected and analyzed the imaging characteristics, and compare the important parameters related to materials respectively in benign and malignant thyroid nodules in tiny features. After comparing with the postoperative results, we selected significant difference indicators, and used statistical theory to calculate the diagnostic efficiency and other related indicators, and compared the diagnostic value of the related main parameters to PTMC. Results: 69 cases of PTMC diagnosed by ultrasound examination of new technology and the postoperative pathological examination results confirmed (107 nodules) patients, 75 thyroid small nodules were confirmed as malignant pathology report, PTMC; another tiny benign thyroid nodules were 32, of which 26 were NG, 3 were small papillary tumor, and 1 for blood clot machine and 1 cases of hyperplasia with calcification. The statistical analysis showed that after the treatment of nodule is detected evenly enhanced, enhanced strength, whether early subsided, whether a rule of edge enhancement and ultrasound elastography score in thyroid benign and malignant nodules showed a significant difference (P0.05) (see Table 1). The sensitivity and specificity of CEUS and UE in diagnosing PTMC were 84%, 68.75%, 93.33% and 90.63%, respectively. The sensitivity and specificity of CEUS and UE two were 96% and 96.88%, respectively, compared with two kinds of tests. Conclusion: (1) CEUS and UE have reliable and practical value for the diagnosis of PTMC, and UE has higher diagnostic efficiency than CEUS. (2) the combination of CEUS and UE can improve the diagnostic sensitivity and accuracy of PTMC.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R736.1

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