本文關(guān)鍵詞：超聲彈性成像和超聲造影對(duì)甲狀腺結(jié)節(jié)診斷價(jià)值的meta分析　出處：《廣西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的：超聲彈性成像(Ultrasonic elastography, UE)和超聲造影(Contrast enhanced ultrasound,CEUS)檢查是鑒別甲狀腺結(jié)節(jié)(Thirod nudles,TN)良惡性的兩種重要手段,也是目前甲狀腺結(jié)節(jié)的診斷及鑒別診斷方面的研究熱點(diǎn)。本研究的目的主要是綜合評(píng)價(jià)UE和CEUS在診斷甲狀腺結(jié)節(jié)方面的價(jià)值。方法：根據(jù)預(yù)先設(shè)定好的英文關(guān)鍵詞:Contrast Media Ultrasonography、 Elasticity Imaging Techniques、Thriod Nodule和中文關(guān)鍵詞：彈性成像、超聲造影、甲狀腺結(jié)節(jié),在Pubmed、Cochrane Library、萬方數(shù)據(jù)庫、中國知網(wǎng)、維普醫(yī)藥信息資源系統(tǒng)網(wǎng)站上進(jìn)行檢索。檢索范圍涵蓋為2015年1月之前所有公開發(fā)表的關(guān)于超聲彈性成像和超聲造影檢查對(duì)甲狀腺結(jié)節(jié)的診斷意義的文獻(xiàn)。以術(shù)后病理或穿刺細(xì)胞學(xué)檢查為金標(biāo)準(zhǔn),提取納入文獻(xiàn)中以上兩種檢查的診斷惡性甲狀腺結(jié)節(jié)的四格表資料(真陽性、真陰性、假陽性、假陰性例數(shù)),以診斷比值比(Diagnositic odd ratio, DOR)為效應(yīng)量對(duì)納入文獻(xiàn)進(jìn)行異質(zhì)性檢驗(yàn),通過meta分析合并診斷效應(yīng)量(敏感性、特異性、陽性似然比、陰性似然比、診斷比值比),擬合總受試者工作特征曲線(summary receiver operating characteristic,SROC),比較超聲彈性成像和超聲造影鑒別甲狀腺結(jié)節(jié)良惡性的診斷效能。結(jié)果：本次meta分析共納入5篇文獻(xiàn),納入甲狀腺結(jié)節(jié)數(shù)549個(gè),其中惡性甲狀腺結(jié)節(jié)218個(gè),良性甲狀腺結(jié)節(jié)331個(gè)。納入文獻(xiàn)研究質(zhì)量均較高。以DOR為效應(yīng)量進(jìn)行異質(zhì)性檢驗(yàn),超聲彈性成像檢查和超聲造影檢查的Cochran-Q值分別為10.35和6.94,P分別為0.0349和0.1392。同時(shí)計(jì)算I2值,分別為61.4%和42.3%。使用隨機(jī)效應(yīng)模型合并診斷效應(yīng)量。超聲彈性成像檢查合并敏感性和特異性及其95%可信區(qū)間(95%Confidence interval,95%CI)為0.83(95%CI,0.78-0.88)和0.87(95%CI,0.83-0.91)。超聲造影檢查合并的敏感性和特異性為0.86(95%CI,0.81-0.91)和0.73(95%CI,0.68-0.77)。超聲彈性成像檢查合并的陽性似然比、陰性似然比和診斷比值比為：6.29(95%CI,4.43-8.92),0.18(95%CI,0.10-0.32),37.07(95%CI,15.62-88.07)。超聲造影檢查合并的陽性似然比、陰性似然性和診斷比值比為：5.76(95%CI,1.13-29.40),0.19(95%CI,0.13-0.30),29.61(95%CI,9.01-97.34)。根據(jù)SROC曲線提示,超聲彈性成像和超聲造影的Q*統(tǒng)計(jì)量分別為0.8590和0.8737,SROC曲線下面積(Area under the curve, AUC)分別為0.9248和0.9371。結(jié)論：超聲彈性成像和超聲造影檢查兩者對(duì)鑒別惡性甲狀腺結(jié)節(jié)都有較高的診斷效能,且超聲造影的診斷價(jià)值要優(yōu)于超聲彈性成像檢查。
[Abstract]:Objective: ultrasonic elastography (Ultrasonic elastography, UE) and contrast-enhanced ultrasound (Contrast enhanced ultrasound, CEUS) examination is the differential diagnosis of thyroid nodules (Thirod nudles, TN) two important means of benign and malignant, is currently the diagnosis and differential diagnosis of thyroid nodules on the hot break. The purpose of this study was to evaluate the value of UE and CEUS in the diagnosis of thyroid nodules. Methods: according to the preset English keyword: Contrast Media Ultrasonography, Elasticity Imaging Techniques, Thriod Nodule and Chinese Keywords: elastography, ultrasonography, thyroid nodules were retrieved in Pubmed, Cochrane, Library, Wanfang database, China CNKI, VIP medical information system website. The search scope covers all published literature on the diagnostic significance of ultrasound elastography and ultrasound contrast examination for thyroid nodules before January 2015. The postoperative pathology or biopsy as the gold standard, extraction of included studies the above two kinds of examinations for the diagnosis of malignant thyroid nodules four data table (true positive, true negative, false positive and false negative cases), the diagnostic odds ratio (Diagnositic odd ratio, DOR) for the amount of literature into effect heterogeneity test, meta analysis by the combined diagnostic effect (sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio), the total fitting receiver operating characteristic curve (summary receiver operating characteristic, SROC), ultrasonic elastography and contrast-enhanced ultrasound in the differential diagnosis of benign and malignant thyroid nodule diagnosis efficacy. Results: 5 articles were included in this meta analysis, including 549 thyroid nodules, of which 218 were malignant thyroid nodules and 331 were benign thyroid nodules. The quality of the study was high. DOR was used to test the heterogeneity. The Cochran-Q values of ultrasound elastography and ultrasound contrast examination were 10.35 and 6.94, respectively, and P was 0.0349 and 0.1392, respectively. At the same time, the I2 values were calculated, 61.4% and 42.3% respectively. The random effect model was used to combine the diagnostic effect. The sensitivity and specificity of ultrasound elastography were 95% (95%Confidence interval, 95%CI) and 0.83 (95%CI, 0.78-0.88) and 0.87 (95%CI, 0.83-0.91), respectively. The sensitivity and specificity of the combined ultrasound examination were 0.86 (95%CI, 0.81-0.91) and 0.73 (95%CI, 0.68-0.77). The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ultrasound elastography were 6.29 (95%CI, 4.43-8.92), 0.18 (95%CI, 0.10-0.32), 37.07 (95%CI, 15.62-88.07). The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of combined ultrasonography were 5.76 (95%CI, 1.13-29.40), 0.19 (95%CI, 0.13-0.30), 29.61 (95%CI, 9.01-97.34). According to the SROC curve, the Q* statistics of ultrasound elastography and contrast-enhanced ultrasound were 0.8590 and 0.8737, respectively. The area under the SROC curve (Area under the curve, AUC) was 0.9248 and 0.9371, respectively. Conclusion: both ultrasound elastography and contrast-enhanced ultrasound have high diagnostic efficiency in differentiating malignant thyroid nodules, and the diagnostic value of CEUS is better than that of ultrasound elastography.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R581;R445.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 魏麗娟;董惠娟;;Meta分析中異質(zhì)性的識(shí)別與處理[J];第二軍醫(yī)大學(xué)學(xué)報(bào);2006年04期

2 張淵;江泉;陳劍;顧曉鳴;章建全;;甲狀腺單發(fā)結(jié)節(jié)三維超聲定性診斷及其ROC曲線分析[J];中國臨床醫(yī)學(xué)影像雜志;2010年01期

3 李霄陽;羅定存;陳利民;賀軍;方陽;;超聲造影對(duì)甲狀腺乳頭狀癌診斷價(jià)值的探討[J];現(xiàn)代實(shí)用醫(yī)學(xué);2009年04期

4 董海英;李萍;寧春平;房世保;;超聲造影定量分析在甲狀腺良惡性結(jié)節(jié)鑒別診斷中的應(yīng)用價(jià)值[J];中華醫(yī)學(xué)超聲雜志(電子版);2013年02期

5 馬姣姣;丁紅;徐本華;毛楓;朱宇莉;徐晨;王文平;;甲狀腺結(jié)節(jié)超聲診斷價(jià)值的探討及最佳量化評(píng)分點(diǎn)的探尋[J];中華醫(yī)學(xué)超聲雜志(電子版);2013年06期

，

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