【摘要】：目的彈性成像技術(shù)存在敏感度差等不利因素,因此限制了該技術(shù)在甲狀腺結(jié)節(jié)診斷中的應(yīng)用,本研究以彈性應(yīng)變率比值(SR)法為基礎(chǔ),針對不同大小的甲狀腺結(jié)節(jié)采用不同的SR計算方法,以探討不同SR計算方法在甲狀腺結(jié)節(jié)良惡性鑒別中的應(yīng)用價值。資料與方法回顧性分析行甲狀腺彈性超聲檢查、超聲引導(dǎo)下甲狀腺細(xì)針穿刺的336例患者共340個結(jié)節(jié),以細(xì)胞病理結(jié)合隨訪為標(biāo)準(zhǔn),分析固定面積法和實際面積法在不同大小甲狀腺結(jié)節(jié)良惡性鑒別中的差異。結(jié)果超聲診斷340個結(jié)節(jié)中,小結(jié)節(jié)91例,大結(jié)節(jié)249例。病理診斷91例小結(jié)節(jié)中惡性36例,良性55例;249例大結(jié)節(jié)中惡性104例,良性145例。對于縱、橫徑均≤8 mm的小結(jié)節(jié),實際面積法判斷惡性腫瘤與病理的一致性更優(yōu)(χ2=20.89,P0.01);對于縱徑/橫徑8 mm的大結(jié)節(jié),固定面積法更優(yōu)(χ2=57.08,P0.01)。實際面積法診斷惡性結(jié)節(jié)的敏感度為57.10%,特異度為83.00%,符合率為72.30%(Kappa=0.413);固定面積法的診斷敏感度為73.60%,特異度為85.00%,符合率為80.30%(Kappa=0.590);根據(jù)結(jié)節(jié)大小選擇性使用兩種方法診斷的敏感度為85.00%,特異度為85.50%,符合率為85.30%(Kappa=0.699)。根據(jù)結(jié)節(jié)大小選擇性使用兩種方法診斷的敏感度最高,與病理診斷的一致性檢驗較單一方法更高(Kappa=0.699,P0.01)。結(jié)論根據(jù)甲狀腺結(jié)節(jié)大小選擇性使用固定面積法和實際面積法可以明顯提高彈性成像診斷惡性甲狀腺結(jié)節(jié)的敏感性。
[Abstract]:Objective to limit the application of elastic imaging technique in the diagnosis of thyroid nodules due to its poor sensitivity and other adverse factors. This study was based on the elastic strain rate ratio (SR) method. Different SR calculation methods were used for thyroid nodules of different sizes to explore the value of different SR calculation methods in differentiating benign and malignant thyroid nodules. Materials and methods A retrospective analysis of 340 nodules was performed in 336 patients with fine needle puncture of thyroid guided by ultrasound. The criteria of cytopathology combined with follow-up were used. To analyze the difference between fixed area method and real area method in differentiating benign and malignant thyroid nodules. Results among 340 nodules diagnosed by ultrasound, 91 were small nodules and 249 were large nodules. Among 91 cases, 36 cases were malignant, 55 cases were benign, 104 cases were malignant and 145 cases were benign. For the small nodules whose longitudinal and transverse diameters were 鈮，

本文編號：2189374