超聲彈性成像應(yīng)變率比值與硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)的臨床價值
發(fā)布時間:2018-02-11 01:22
本文關(guān)鍵詞: 超聲彈性成像 應(yīng)變率比值 甲狀腺良性結(jié)節(jié) 甲狀腺惡性結(jié)節(jié) 出處:《中國超聲醫(yī)學(xué)雜志》2017年05期 論文類型:期刊論文
【摘要】:目的對比超聲彈性成像應(yīng)變率比值與硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)的臨床價值。方法選取我院收治的114例甲狀腺良性結(jié)節(jié)患者、135個結(jié)節(jié)(對照組),119例甲狀腺惡性結(jié)節(jié)患者、141個結(jié)節(jié)(病例組)作為研究對象。所有結(jié)節(jié)術(shù)前均接受超聲彈性成像檢查,以病理檢查為甲狀腺良惡性結(jié)節(jié)鑒別診斷的金標準,繪制應(yīng)變率比值、硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)的受試者工作特征曲線(ROC曲線),求得ROC曲線下面積(AUC)、最佳鑒別診斷閾值以及對應(yīng)的靈敏度、特異度等指標。結(jié)果 (1)病例組應(yīng)變率比值、硬度分級顯著高于對照組,兩組差異有統(tǒng)計學(xué)意義(P0.05)。(2)應(yīng)變率比值鑒別診斷甲狀腺良惡性結(jié)節(jié)的AUC為0.895,其95%可信區(qū)間(CI)為0.865~0.949。結(jié)節(jié)硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)的AUC為0.882,其95%CI為0.859~0.937。應(yīng)變率比值、硬度分級的AUC比較差異無統(tǒng)計學(xué)意義(P0.05)。(3)應(yīng)變率比值鑒別診斷甲狀腺良惡性結(jié)節(jié)的最佳鑒別診斷閾值為3.14,其對應(yīng)的靈敏度、特異度分別為85.11%、89.63%。硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)標準≤Ⅱ級為良性,Ⅱ級為惡性,其對應(yīng)的靈敏度、特異度分別為83.69%、88.89%。結(jié)論超聲彈性成像應(yīng)變率比值與硬度分級鑒別診斷甲狀腺良惡性結(jié)節(jié)的臨床價值相當,兩個指標均有良好的靈敏度及特異度。
[Abstract]:Objective to compare the clinical value of ultrasonic elastic imaging strain rate ratio and hardness grading in the differential diagnosis of benign and malignant thyroid nodules. Methods 114 patients with benign thyroid nodules and 135 thyroid nodules (control group, 119 patients with thyroid shape) were selected in our hospital. 141 nodules (case group) were included in the study. All the nodules were examined by elastography before operation. Pathological examination was used as the gold standard for differential diagnosis of benign and malignant thyroid nodules, and the strain rate ratio was plotted. The operating characteristic curve of the patients with differential diagnosis of benign and malignant thyroid nodules by hardness classification was used to obtain the area under the ROC curve, the best differential diagnostic threshold, the corresponding sensitivity, specificity and so on. Results: the strain rate ratio of the case group was determined. The hardness grade was significantly higher than that of the control group. The difference between the two groups was statistically significant (P < 0.05). The strain rate ratio was 0.895in the differential diagnosis of benign and malignant thyroid nodules, and 0.865 ~ 0.949 in the 95% confidence interval (CI). The AUC was 0.882in the diagnosis of benign and malignant thyroid nodules by nodular hardness classification, and the strain rate ratio was 0.859 ~ 0.937 in 95 CI. There was no significant difference in AUC of hardness grade (P 0.05). The best diagnostic threshold for the differential diagnosis of benign and malignant thyroid nodules was 3.14, and the corresponding sensitivity was 3.14. The specificity was 85.11% and 89.63%, respectively. The criteria for the differential diagnosis of benign and malignant thyroid nodules by hardness grade were 鈮,
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