超声弹性成像应变率比值与硬度分级鉴别诊断甲状腺良恶性结节的临床价值

发布时间：2018-02-11 01:22

  本文关键词： 超声弹性成像 应变率比值 甲状腺良性结节 甲状腺恶性结节　出处：《中国超声医学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的对比超声弹性成像应变率比值与硬度分级鉴别诊断甲状腺良恶性结节的临床价值。方法选取我院收治的114例甲状腺良性结节患者、135个结节(对照组),119例甲状腺恶性结节患者、141个结节(病例组)作为研究对象。所有结节术前均接受超声弹性成像检查,以病理检查为甲状腺良恶性结节鉴别诊断的金标准,绘制应变率比值、硬度分级鉴别诊断甲状腺良恶性结节的受试者工作特征曲线(ROC曲线),求得ROC曲线下面积(AUC)、最佳鉴别诊断阈值以及对应的灵敏度、特异度等指标。结果 (1)病例组应变率比值、硬度分级显著高于对照组,两组差异有统计学意义(P0.05)。(2)应变率比值鉴别诊断甲状腺良恶性结节的AUC为0.895,其95%可信区间(CI)为0.865~0.949。结节硬度分级鉴别诊断甲状腺良恶性结节的AUC为0.882,其95%CI为0.859~0.937。应变率比值、硬度分级的AUC比较差异无统计学意义(P0.05)。(3)应变率比值鉴别诊断甲状腺良恶性结节的最佳鉴别诊断阈值为3.14,其对应的灵敏度、特异度分别为85.11%、89.63%。硬度分级鉴别诊断甲状腺良恶性结节标准≤Ⅱ级为良性,Ⅱ级为恶性,其对应的灵敏度、特异度分别为83.69%、88.89%。结论超声弹性成像应变率比值与硬度分级鉴别诊断甲状腺良恶性结节的临床价值相当,两个指标均有良好的灵敏度及特异度。
[Abstract]:Objective to compare the clinical value of ultrasonic elastic imaging strain rate ratio and hardness grading in the differential diagnosis of benign and malignant thyroid nodules. Methods 114 patients with benign thyroid nodules and 135 thyroid nodules (control group, 119 patients with thyroid shape) were selected in our hospital. 141 nodules (case group) were included in the study. All the nodules were examined by elastography before operation. Pathological examination was used as the gold standard for differential diagnosis of benign and malignant thyroid nodules, and the strain rate ratio was plotted. The operating characteristic curve of the patients with differential diagnosis of benign and malignant thyroid nodules by hardness classification was used to obtain the area under the ROC curve, the best differential diagnostic threshold, the corresponding sensitivity, specificity and so on. Results: the strain rate ratio of the case group was determined. The hardness grade was significantly higher than that of the control group. The difference between the two groups was statistically significant (P < 0.05). The strain rate ratio was 0.895in the differential diagnosis of benign and malignant thyroid nodules, and 0.865 ~ 0.949 in the 95% confidence interval (CI). The AUC was 0.882in the diagnosis of benign and malignant thyroid nodules by nodular hardness classification, and the strain rate ratio was 0.859 ~ 0.937 in 95 CI. There was no significant difference in AUC of hardness grade (P 0.05). The best diagnostic threshold for the differential diagnosis of benign and malignant thyroid nodules was 3.14, and the corresponding sensitivity was 3.14. The specificity was 85.11% and 89.63%, respectively. The criteria for the differential diagnosis of benign and malignant thyroid nodules by hardness grade were 鈮，

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