發(fā)布時間：2018-04-02 14:25

  本文選題：甲狀腺影像報告與評分系統　切入點：彈性成像　出處：《醫(yī)學研究生學報》2015年10期

【摘要】：目的高頻超聲的廣泛應用使得甲狀腺結節(jié)的檢出率逐年增加。文中旨在探討常規(guī)超聲、彈性成像及兩者聯合應用對甲狀腺良惡性結節(jié)的診斷價值。方法回顧性分析南京軍區(qū)南京總醫(yī)院2014年9月至2015年8月105例甲狀腺結節(jié)患者的160枚甲狀腺結節(jié)超聲圖像,通過繪制甲狀腺影像報告與評分系統(thyroid imaging reporting and data system,TI-RADS)評分、彈性評分和聯合評分ROC曲線,計算并比較曲線下面積,選取合適截斷點,分別計算3種方法的診斷效能,并與病理結果進行Kappa一致性檢驗。結果聯合評分的ROC曲線的曲線下面積(0.930,95%CI:0.890~0.969)大于TI-RADS評分(0.855,95%CI:0.794~0.915)和彈性評分(0.845,95%CI:0.780~0.909),差異均有統計學意義(P0.05)。以TI-RADS≥4分,彈性評分≥3分及聯合評分≥7分為診斷甲狀腺惡性結節(jié)的界點,聯合評分的特異度、陽性預測值(94.3%、91.7%)均高于TI-RDAS評分(78.4%、84.7%)和彈性評分(81.8%、78.7%)。聯合評分的敏感度低于彈性評分和TI-RDAS評分,而其NPV高于TI-RDAS評分,低于彈性評分。聯合評分的Kappa值(0.718,95%CI:0.610~0.826)均高于TIRDAS評分(0.586,95%CI:0.461~0.711)和彈性評分(0.635,95%CI:0.515~0.755)。結論常規(guī)超聲與彈性成像相互補充,聯合評分較單一檢查方法具有更高的診斷價值。
[Abstract]:Objective the detection rate of thyroid nodules increases year by year with the wide use of high frequency ultrasound.The purpose of this paper is to evaluate the diagnostic value of conventional ultrasound, elastic imaging and combined use of both in benign and malignant thyroid nodules.Methods 160 thyroid nodules from 105 patients with thyroid nodules in Nanjing General Hospital of Nanjing military region from September 2014 to August 2015 were analyzed retrospectively. Thyroid imaging reporting and data system TI-RADSs were evaluated by drawing the thyroid imaging report and scoring system.The area under the curve was calculated and compared, the suitable truncation point was selected, the diagnostic efficacy of the three methods was calculated, and the consistency test of Kappa with pathological results was carried out.Results the area under the curve of the joint score ROC curve was 0.930 / 95 CI: 0.890 / 0.969) which was larger than that of the TI-RADS score of 0.85595% 0.794 / 0.915) and the elastic score of 0.84595% was 0.909%. The difference was statistically significant (P 0.05).TI-RADS 鈮，

本文編號：1700807