本文選題：甲狀腺影像報(bào)告與數(shù)據(jù)系統(tǒng)　切入點(diǎn)：聲觸診組織量化技術(shù)　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討甲狀腺影像報(bào)告與數(shù)據(jù)系統(tǒng)(TI-RADS)分類、聲觸診組織量化(Virtual Tough Tissues Quantification,VTQ)技術(shù)及超聲造影(contrast-enhanced ultrasonography,CEUS)鑒別診斷甲狀腺結(jié)節(jié)良惡性的價(jià)值。方法對(duì)66例患者69個(gè)結(jié)節(jié)均于術(shù)前進(jìn)行TI-RADS分類、超聲造影,觀察并分析其超聲造影表現(xiàn)。應(yīng)用VTQ測(cè)定結(jié)節(jié)剪切波速度(Shear Wave Velocity,SWV),通過繪制ROC曲線獲得SWV的曲線下面積及最佳臨界值。計(jì)算三種方法單獨(dú)及兩兩聯(lián)合的靈敏度,特異度,陽性預(yù)測(cè)值,陰性預(yù)測(cè)值及準(zhǔn)確率。結(jié)果69個(gè)甲狀腺結(jié)節(jié)中,良性37個(gè),惡性32個(gè)。TI-RADS分類診斷甲狀腺惡性結(jié)節(jié)的靈敏度、特異度、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、準(zhǔn)確率分別為78.13%,70.27%,69.44%,78.79%,73.91%。SWV以2.55m/s為最佳臨界值,ROC曲線下面積為0.808,其靈敏度、特異度、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、準(zhǔn)確率分別為87.50%,86.49%,84.85%,88.89%,86.96%。超聲造影診斷甲狀腺惡性結(jié)節(jié)的靈敏度、特異度、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、準(zhǔn)確率分別為65.63%,91.89%,87.50%,75.56%,79.71%。VTQ聯(lián)合超聲造影的靈敏度、特異度、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、準(zhǔn)確率分別為93.75%,78.38%,78.95%,93.55%,85.51%。3種方法單獨(dú)診斷時(shí),VTQ診斷甲狀腺結(jié)節(jié)良惡性的敏感度最高,CEUS特異度最高;兩兩聯(lián)合應(yīng)用時(shí),VTQ和CEUS聯(lián)合診斷甲狀腺結(jié)節(jié)良惡性的敏感度最高。結(jié)論三種方法對(duì)診斷甲狀腺結(jié)節(jié)良惡性有一定價(jià)值,VTQ聯(lián)合超聲造影的敏感度最高,是鑒別甲狀腺結(jié)節(jié)良惡性的可靠檢查手段。
[Abstract]:Objective to evaluate the value of TI-RADS classification, acoustic palpation tissue quantification (VTQQ) and contrast-enhanced ultrasound scanning (CEUSS) in the differential diagnosis of benign and malignant thyroid nodules. Methods Sixty-six patients with 69 nodules were classified by TI-RADS before operation. VTQ was used to determine the shear Wave velocity of the nodules and the area under the curve and the optimum critical value of the SWV were obtained by drawing the ROC curve. The sensitivity of the three methods was calculated separately and in combination. Results the sensitivity, specificity, positive predictive value, positive predictive value, negative predictive value and negative predictive value of thyroid nodule in 39 thyroid nodules were 37 benign and 32 malignant. The accuracy was 78.130.27 and 78.797.The area under the ROC curve was 0.808.The sensitivity, specificity, positive predictive value and negative predictive value of SWV were 0.808. The sensitivity, specificity, positive predictive value and negative predictive value of the ROC curve were 87.50 and 86.4984.858.898986.96.The sensitivity, specificity and specificity of contrast-enhanced ultrasonography in the diagnosis of malignant thyroid nodules. The sensitivity, specificity, positive predictive value, positive predictive value, negative predictive value, and negative predictive value were 75.56, 79.71, 79.71 and 79.71, respectively, and the positive predictive value, negative predictive value, negative predictive value, positive predictive value, negative predictive value, positive predictive value and negative predictive value, respectively, of the positive predictive value and the negative predictive value were 65.63 and 91.89, respectively. The sensitivity of VTQ in diagnosis of benign and malignant thyroid nodules was the highest and the specificity of CEUs was the highest when the accuracy was 93.75 and 78.38 and 78.95 and 93.555.51, respectively. The sensitivity of VTQ combined with CEUS in the diagnosis of benign and malignant thyroid nodules is the highest. Conclusion these three methods are of great value in the diagnosis of benign and malignant thyroid nodules and the sensitivity of VTQ combined with contrast-enhanced ultrasonography is the highest. It is a reliable method for differentiating benign and malignant thyroid nodules.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R581

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