聲速匹配技術(shù)在甲狀腺疾病診斷中的應(yīng)用價(jià)值
發(fā)布時(shí)間：2018-12-19 07:11
【摘要】：目的通過(guò)聲速匹配技術(shù)測(cè)定甲狀腺疾病的聲速匹配值，探討其在甲狀腺疾病診斷及鑒別診斷中的應(yīng)用價(jià)值及其測(cè)定過(guò)程中的影響因素。 方法1選取原發(fā)性甲亢(graves)患者34例，橋本氏甲狀腺炎(Hashimoto'sthyroiditis,HT)患者41例，正常對(duì)照組52例；二維彩超常規(guī)觀察甲狀腺大小、實(shí)質(zhì)、血流，并測(cè)量甲狀腺被膜距體表厚度；啟動(dòng)聲速匹配技術(shù)測(cè)量甲狀腺呼吸前、后聲速匹配值（zone speed index，ZSI）各6次，分別計(jì)算屏住呼吸前、后ZSI的ICC（組內(nèi)相關(guān)系數(shù)），并計(jì)算屏住呼吸后ZSI的平均值，從而得出該區(qū)域的聲速（The speed of sound，SV）為（1540+ZSI）m/s。對(duì)兩組患者的ZSI值進(jìn)行分析，用組內(nèi)相關(guān)系數(shù)（ICC)預(yù)測(cè)其穩(wěn)定性。2選取經(jīng)手術(shù)病理證實(shí)的65例患者的77個(gè)甲狀腺結(jié)節(jié)，其中良性結(jié)節(jié)51個(gè)（結(jié)節(jié)性甲狀腺腫38個(gè)，腺瘤13個(gè)），惡性結(jié)節(jié)26個(gè)(乳頭狀癌20個(gè)，濾泡狀癌4個(gè)，未分化癌1個(gè)，梭形巨細(xì)胞瘤1個(gè))，二維常規(guī)觀察甲狀腺結(jié)節(jié)大小、回聲、血流、邊界、鈣化、囊變，并測(cè)量結(jié)節(jié)的大小及結(jié)節(jié)上緣距體表的距離，啟動(dòng)聲速匹配技術(shù)，測(cè)量77個(gè)結(jié)節(jié)的聲速匹配值，以病理結(jié)果作為金標(biāo)準(zhǔn)，構(gòu)建ROC曲線，判斷聲速匹配技術(shù)對(duì)甲狀腺良惡性結(jié)節(jié)的診斷價(jià)值，并分析結(jié)節(jié)的深度與ZSI的關(guān)系。 結(jié)果1HT組的SV高于正常組及Graves組，Graves組的SV低于正常組，三者比較兩兩之間差異均有統(tǒng)計(jì)學(xué)意義（P 0.05）；聲速匹配技術(shù)測(cè)定甲狀腺疾病的聲速匹配值具有很好的穩(wěn)定性（ICC0.90），但受呼吸影響大；甲狀腺被膜距體表厚度與ZSI無(wú)相關(guān)性。2甲狀腺良性結(jié)節(jié)的ZSI值低于惡性結(jié)節(jié)，差異有統(tǒng)計(jì)學(xué)意義（P 0.05）。ROC曲線下面積0.91，ZSI判斷良、惡性結(jié)節(jié)的最佳臨界點(diǎn)為39.17m/s，以此為界點(diǎn)ZSI判別甲狀腺惡性結(jié)節(jié)的敏感性、特異性分別為92%、85%。甲狀腺結(jié)節(jié)的深度與ZSI無(wú)顯著相關(guān)性（良性結(jié)節(jié)r=0.05，P=0.72，惡性結(jié)節(jié)r=0.04，P=0.83）。 結(jié)論1聲速匹配技術(shù)作為一項(xiàng)新技術(shù)，測(cè)甲狀腺聲速時(shí)，屏住呼吸后ICC0.90，說(shuō)明屏住呼吸后聲速匹配技術(shù)具有很好的穩(wěn)定性。2橋本氏甲狀腺炎的聲速高于原發(fā)性甲亢及正常對(duì)照組，原發(fā)性甲亢的聲速匹配值低于正常對(duì)照組；惡性結(jié)節(jié)的聲速高于良性結(jié)節(jié)，通過(guò)構(gòu)建良、惡性結(jié)節(jié)的ROC曲線得出聲速匹配技術(shù)判斷甲狀腺良、惡性結(jié)節(jié)的最佳臨界點(diǎn)為39.17cm/s，，敏感性、特異性分別為92%、85%。聲速匹配技術(shù)可以為診斷及鑒別診斷甲狀腺疾病提供客觀參考依據(jù)。3聲速匹配技術(shù)測(cè)甲狀腺疾病聲速時(shí)與超聲聲波所經(jīng)甲狀腺疾病前方組織無(wú)相關(guān)性。
[Abstract]:Objective to study the value of ultrasonic velocity matching in the diagnosis and differential diagnosis of thyroid diseases and its influencing factors. Methods 1Thirty-four patients with primary hyperthyroidism (graves), 41 patients with Hashimoto's thyroiditis (Hashimoto'sthyroiditis,HT) and 52 normal controls were selected. The size, parenchyma and blood flow of thyroid gland were observed by two-dimensional color Doppler ultrasound, and the thickness of thyroid capsule from body surface was measured. The ICC (intra-group correlation coefficient) of ZSI before and after holding the breath was calculated, and the mean value of ZSI after holding the breath was calculated. The sound velocity (The speed of sound,SV of the region is (1540 ZSI) m / s. The ZSI values of the two groups were analyzed, and the stability of the patients was predicted by intra-group correlation coefficient (ICC). 2Seventy-seven thyroid nodules were selected from 65 patients confirmed by surgery and pathology, including 51 benign nodule (38 nodular goiter). 13 adenomas, 26 malignant nodules (20 papillary carcinomas, 4 follicular carcinomas, 1 undifferentiated carcinoma, 1 spindle giant cell tumor). The size of the nodules and the distance from the upper edge of the nodules to the body surface were measured. The sound velocity matching values of 77 nodules were measured by starting the sound velocity matching technique. The ROC curves were constructed according to the pathological results as the gold standard. To evaluate the diagnostic value of ultrasonic velocity matching technique in benign and malignant thyroid nodules, and to analyze the relationship between the depth of thyroid nodules and ZSI. Results the SV of 1HT group was higher than that of normal group and Graves group, and the SV of Graves group was lower than that of normal group. The sound velocity matching value of thyroid disease measured by sound velocity matching technique has good stability (ICC0.90), but it is greatly affected by respiration. The ZSI value of benign thyroid nodules was lower than that of malignant nodules, and the difference was statistically significant (P < 0. 05). ROC curve). The best critical point for malignant nodules was 39.17 m / s, and the sensitivity of ZSI as a boundary point for the diagnosis of malignant thyroid nodules was 92% and 85%, respectively. There was no significant correlation between the depth of thyroid nodule and ZSI (benign nodule was 0. 05% P0. 72, malignant nodule was 0. 04% P0. 83). Conclusion (1) as a new technique, the supersonic velocity matching technique is a new technique for measuring thyroid sound velocity, ICC0.90, after holding one's breath. 2 the sound velocity of Hashimoto's thyroiditis was higher than that of primary hyperthyroidism and normal control group, and the matching value of acoustic velocity of primary hyperthyroidism was lower than that of normal control group. The sound velocity of malignant nodules was higher than that of benign ones. The ROC curves of benign and malignant nodules were constructed to determine the benign thyroid gland. The optimal critical point for malignant nodules was 39.17 cm / s, with sensitivity and specificity of 92 ~ 85 cm / s, respectively. Sonic velocity matching technique can provide an objective reference for diagnosis and differential diagnosis of thyroid diseases. 3 there is no correlation between ultrasonic velocity matching technique and anterior tissue of thyroid disease.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R581;R445.1
本文編號(hào)：2386581
[Abstract]:Objective to study the value of ultrasonic velocity matching in the diagnosis and differential diagnosis of thyroid diseases and its influencing factors. Methods 1Thirty-four patients with primary hyperthyroidism (graves), 41 patients with Hashimoto's thyroiditis (Hashimoto'sthyroiditis,HT) and 52 normal controls were selected. The size, parenchyma and blood flow of thyroid gland were observed by two-dimensional color Doppler ultrasound, and the thickness of thyroid capsule from body surface was measured. The ICC (intra-group correlation coefficient) of ZSI before and after holding the breath was calculated, and the mean value of ZSI after holding the breath was calculated. The sound velocity (The speed of sound,SV of the region is (1540 ZSI) m / s. The ZSI values of the two groups were analyzed, and the stability of the patients was predicted by intra-group correlation coefficient (ICC). 2Seventy-seven thyroid nodules were selected from 65 patients confirmed by surgery and pathology, including 51 benign nodule (38 nodular goiter). 13 adenomas, 26 malignant nodules (20 papillary carcinomas, 4 follicular carcinomas, 1 undifferentiated carcinoma, 1 spindle giant cell tumor). The size of the nodules and the distance from the upper edge of the nodules to the body surface were measured. The sound velocity matching values of 77 nodules were measured by starting the sound velocity matching technique. The ROC curves were constructed according to the pathological results as the gold standard. To evaluate the diagnostic value of ultrasonic velocity matching technique in benign and malignant thyroid nodules, and to analyze the relationship between the depth of thyroid nodules and ZSI. Results the SV of 1HT group was higher than that of normal group and Graves group, and the SV of Graves group was lower than that of normal group. The sound velocity matching value of thyroid disease measured by sound velocity matching technique has good stability (ICC0.90), but it is greatly affected by respiration. The ZSI value of benign thyroid nodules was lower than that of malignant nodules, and the difference was statistically significant (P < 0. 05). ROC curve). The best critical point for malignant nodules was 39.17 m / s, and the sensitivity of ZSI as a boundary point for the diagnosis of malignant thyroid nodules was 92% and 85%, respectively. There was no significant correlation between the depth of thyroid nodule and ZSI (benign nodule was 0. 05% P0. 72, malignant nodule was 0. 04% P0. 83). Conclusion (1) as a new technique, the supersonic velocity matching technique is a new technique for measuring thyroid sound velocity, ICC0.90, after holding one's breath. 2 the sound velocity of Hashimoto's thyroiditis was higher than that of primary hyperthyroidism and normal control group, and the matching value of acoustic velocity of primary hyperthyroidism was lower than that of normal control group. The sound velocity of malignant nodules was higher than that of benign ones. The ROC curves of benign and malignant nodules were constructed to determine the benign thyroid gland. The optimal critical point for malignant nodules was 39.17 cm / s, with sensitivity and specificity of 92 ~ 85 cm / s, respectively. Sonic velocity matching technique can provide an objective reference for diagnosis and differential diagnosis of thyroid diseases. 3 there is no correlation between ultrasonic velocity matching technique and anterior tissue of thyroid disease.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R581;R445.1
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相關(guān)期刊論文 前2條
1 王靜;;彩超檢查甲狀腺疾病124例診斷分析[J];中國(guó)醫(yī)藥指南;2011年03期
2 吳茂英;;彩超觀測(cè)甲狀腺上動(dòng)脈內(nèi)徑及血流峰值變化對(duì)甲亢的療效評(píng)估[J];中國(guó)醫(yī)藥指南;2012年30期
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