弹性成像在甲状腺、乳腺结节及淋巴结良恶性鉴别中的应用

发布时间：2018-05-03 13:12

本文选题：常规超声 + 弹性成像　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的本课题旨在应用超声弹性成像技术,分析其在甲状腺结节、乳腺结节、淋巴结中的应用价值。方法先用常规超声观察甲状腺结节、乳腺结节及浅表淋巴结大小、形态、血供等,并转换成弹性成像模式,作出相应的弹性硬度评分,计算弹性应变率比值;以术后病理结果作为金标准,常规超声和弹性成像的检查结果分别与病理结果进行比较,分析这两种方法诊断肿块良恶性的敏感性、特异性、准确性,并用SPSS19.0软件和Medcalc软件对所得结果进行统计分析。结果弹性成像在甲状腺结节、乳腺结节、淋巴结诊断的符合率均高于常规超声,差异均有统计学意义(P0.05)。常规超声检出甲状腺良恶性结节灵敏度68.89%,特异度65.71%,阳性预测值72.09%,阴性预测值62.15%,符合率67.50%;检查乳腺良恶性结节的灵敏度62.5%,特异度66.67%,阳性预测值76.92%,阴性预测值50%,符合度64%;检查浅表良恶性淋巴结的灵敏度60%,特异度70.97%,阳性预测值57.14%,阴性预测值70.97%,符合率66.67%。应变弹性超声检出甲状腺良恶性结节灵敏度82.22%,特异度80%,阳性预测值84.09%,阴性预测值77.78%,符合率81.25%;检出乳腺良恶性结节灵敏度84.38%,特异度83.33%,阳性预测值90%,阴性预测值75%,符合率84%;检出浅表淋巴结灵敏度80%,特异度80.65%,阳性预测值72.72%,阴性预测值86.21%,符合率80.39%。甲状腺结节良恶性鉴别诊断的SR临界点为3.89;乳腺结节良恶性鉴别诊断的临界点为2.91;头颈部良恶性淋巴结鉴别诊断的临界点为1.31;双侧腋窝良恶性淋巴结鉴别诊断SR临界点为2.23。结论弹性成像技术有助于鉴别诊断甲状腺结节、乳腺结节及浅表淋巴结的的良恶性。
[Abstract]:Objective to analyze the value of ultrasound elastic imaging in thyroid nodule, mammary nodule and lymph node. Methods the size, shape and blood supply of thyroid nodule, mammary nodule and superficial lymph node were observed by conventional ultrasound, and then converted into elastic imaging mode. The corresponding elastic hardness score was made and the ratio of elastic strain rate was calculated. The results of conventional ultrasound and elastic imaging were compared with those of pathology, and the sensitivity, specificity and accuracy of these two methods in the diagnosis of benign and malignant tumors were analyzed. The results were statistically analyzed by SPSS19.0 and Medcalc software. Results the coincidence rate of elastic imaging in the diagnosis of thyroid nodule, mammary nodule and lymph node was higher than that of conventional ultrasound, and the difference was statistically significant (P 0.05). The sensitivity, specificity, positive predictive value and negative predictive value were 68.89, 65.71, 72.09, 62.15 and 67.50, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of benign and malignant nodules were 62.5, 66.67, 76.92 and 50, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of superficial benign and malignant lymph nodes were 60, 70.97, 57.14, 70.97, 66.67, respectively. The sensitivity, specificity, positive predictive value and negative predictive value were 82.22, 80, 84.09, 77.78, 81.25, 84.38, 83.33, 90, 75, 77.78, 77.78, 84.38, 83.33, 90, 77.78, 77.78, 84.38, 83.33, 90 and 75, respectively. The sensitivity of superficial lymph nodes was 80%, the specificity was 80.65, the positive predictive value was 72.722, the negative predictive value was 86.21, the coincidence rate was 80.39. The SR critical point was 3.89 for benign and malignant thyroid nodules, 2.91 for benign and malignant breast nodules, 1.31 for benign and malignant lymph nodes in head and neck, and 2.23 for bilateral axillary benign and malignant lymph nodes. Conclusion Elastic imaging is helpful in differential diagnosis of benign and malignant thyroid nodules, breast nodules and superficial lymph nodes.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R730.44

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