摘要
目的探讨超声弹性成像应变率比值（SR）对甲状腺结节良恶性的诊断价值及其影响因素。方法对经细针穿刺及手术病理证实的225个甲状腺结节进行超声弹性成像,与病理结果对照,应用ROC曲线确定SR值的最佳临界值;采用多元线性回归分析甲状腺结节直径、内部结构及是否合并桥本及钙化等因素对甲状腺结节SR值的影响。结果良性结节SR为0.95±0.48,恶性结节SR为0.39±0.14,二者比较差异有统计学意义（P〈0.01）。以术后病理结果为标准,获取ROC曲线曲线下面积为0.915（95%CI,0.878-0.953）,以SR〈0.50作为诊断恶性结节的标准,其准确性86.22%,敏感性85.65%,特异性86.68%。多元线性回归分析显示甲状腺结节合并桥本及结节伴钙化对SR值有影响。结论 SR值可定量评价甲状腺结节硬度,为甲状腺结节良恶性鉴别提供了一种新的诊断指标,在临床诊断中具有良好的应用价值。
Objective To evaluate the value of quantitative analysis in the benign and malignant thyroid nodule by ultrasonic elastosonography strain ratio（SR）and its influential factors. Methods Two hundred and twenty-five thyroid nodules were included in the study.A total of thyroid nodules were examined by traditional ultrasonography and elastosonography from which the SR were derived,with pathologic results as the reference standard.And a ROC curve was used to identify the value of optimal operating point for differential diagnosis of thyroid nodules. The multivariate regression analysis was used to identify the prognostic factors in PTC.Results The SR of benign nodules were 0.95±0.48,which were significantly different from the value of malignant nodule 0.39±0.14（P〈0.001）.The area under the ROC curve was 0.915（95%CI,0.878-0.953）,which showed a high statistical significance. It showed that the optimal operating point of ROC curve was 0.50,with high accuracy（86.22%）,sensitivity（85.65%）and specificity（86.68%）. The result of multivariate regression analysis were Hashimoto＇s thyroiditis or thyroid nodules with calcium with significant differences in the prognostic factors in thyroid nodule. Conclusion The SR of ultrasonic elastosonography can provide a quantitative tool for evaluating the thyroid nodules. Hashimoto＇s thyroiditis or thyroid nodules with calcium will affect the result of SR.
出处
《临床超声医学杂志》
2015年第11期745-747,共3页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
弹性成像
应变率比值
结节
甲状腺
良恶性
Ultrasonography
elastography
Strain rate ratio
Nodules
thyroid
malignant and benign
