摘要
目的探讨应用彩色多普勒超声(CDUS)诊断甲状腺微小癌(TMC)的实用价值。方法以手术病理检查结果为金标准,将114个甲状腺微小肿块分为观察组(TMC肿块51块)和对照组(良性肿块63块)。对两组CDUS征象进行回顾性分析,采用Logistic回归分析筛选与TMC相关联CDUS特征参数,建立诊断预测模型。结果观察组出现纵横比>1、边界模糊、内部低回声、周边无声晕、微小钙化、血流阻力指数(RI)>0.70所占百分比均高于对照组(P<0.01)。两组血流信号分布不同(P<0.01)。多因素逐步Logistic回归分析结果显示,周边无声晕、边界模糊、RI>0.70、内部低回声和血流信号≤2级与TMC相关(P<0.05)。采用上述5个指标建立的回归模型预测TMC的灵敏度、特异度和准确性分别为93.75%、90.90%、92.11%,预测效果较好。结论以CDUS的回声、边界、RI和血流信号建立的Logistic回归模型有助于TMC的早期诊断。
Objective To evaluate the diagnostic value of color Doppler ultrasound （CDUS ） in thyroid microcarcinom （TMC）. Methods With surgical pathologic examination results as the gold standard, 114 thyroid lumps were divided in-to observation group （including 51 pieces of TMC lump）and control group （including 63 pieces of benign lump）. The sign of CDUS were analyzed retrospectively in the two groups. Logistic regression analysis was used to screen the CDUS characteristic parameters which associated with TMC and established TMC diagnosis prediction model. Results The percentage of anteroposterior and transverse diameter ratio（A/T）〉1, unclear edge, hypoechoic nodules, absent halo sign, micro calcifications, resistance index（RI）〉0.70 of the observation group were higher than those of the control group（P〈0.01）. Blood flow signal distribution in the 2 groups were different significantly （P〈0.01）. Multi-factor stepwise Logistic regression analysis results show that the absent halo sign, unclear edge, RI〉0.70, hypoechoic nodules and blood flow signal ≤2 were associated with TMC （P〈0.05）. The above five indexes were used to establish regression model to pre-dict TMC and the sensitivity, specific degrees and accuracy were 93.75%, 90.90%, 92.11%. Conclusion The Logistic regression model with echo, edge, RI and blood flow signal in CDUS can be helpful for early accurate diagnosis of TMC.
出处
《中国现代医生》
2014年第25期44-47,F0003,共5页
China Modern Doctor
关键词
甲状腺
微小癌
彩色多普勒超声
诊断
Thyroid Micro carcinoma Color Doppler ultrasound Diagnosis
