摘要
目的探讨热断层成像(TTM)检查对甲状腺和乳腺疾病筛查的应用价值。方法以2010年1月—2014年12月在解放军总医院行健康体检的人群为研究对象,其中甲状腺检查1562例,乳腺检查452例,以B型超声检查结果为金标准,比较分析TTM,手法触诊对甲状腺和乳腺检查的诊断价值。结果 1 562例甲状腺检查对象中,女性甲状腺超声异常检出率明显高于男性(65.71%vs.46.94%,X^2=45.37,P=0.000)。452例女性乳腺体检者中,乳腺超声检查异常率66.15%,乳腺异常组年龄小于乳腺正常组[(51.53±6.94)岁vs.(54.42±8.06)岁,t=3.96,P=0.000]。甲状腺手法触诊和TTM检查特异度较高,乳腺手法触诊和TTM检查灵敏度较高。无论是手法触诊还是TTM检查,与B型超卢检查比较,可靠性均较差(Youden指数为0.138 6~0.221 8)。以B型超声检查结果为金标准,甲状腺手法触诊、TTM检查与超声检查一致性较差(Kappa=0.215 0、0.137 6)。乳腺手法触诊与超声检查一致性较差(Kappa=0.191 0);乳腺TTM检查与超声检查一致性中等(Kappa=0.562 5)。甲状腺、乳腺手法触诊检查、TTM检查与超声检查一致性的ROC曲线下面积(AUC)分别是0.61、0.59、0.56和0.57。结论 TTM在甲状腺疾病筛查中与B型超声检查比较,一致性较差;在乳腺疾病筛查中与超声检查一致性呈中等水平。与B型超声检查比较,TTM作为诊断方法诊断准确性较低。因此,其应用价值需要进一步探讨。
Objective To investigate the clinical value of the thermal texture maps（TTM） in the screening of thyroid and breast diseases.Methods An investigation including 1 562 people selected with thyroid TTM scan and 452 women selected with breast TTM scan were performed retrospectively from Januan 2010 to December 2014,and the diagnostic values of thyroid and breast examination with TTM and manual palpation were compared.The ultrasonograms of thyroid and breast of all the people were obtained as the ＂ golden standard＂.Results Among the 1 562 cases,the detection rate of abnormal ultrasonograms in the female group was higher than that in the male group（65.71%vs.46.94%,χ-2 =45.37,P =0.000）.The abnormality rale in the breast ultrasonograms was 66.15%.The age in the abnormal ultrasonograms group than in the normal group（51.53 ±6.94） years vs.（54.42 ±8.06） years,t =3.96,P =0.000].The reliabilities of the palpation and TTM showed poorer in the groups of thyroid and breast in comparation with ultrasonograpy（Youden indices were 0.138 6-0.221 8 respctively）.Based on the results of ultrasonograpy,the results of the palpation and TTM were not in good agreement with that of ultrasonography in the thyroid group（Kappa values were 0.215 0,0.137 6）,as well as the palpation in breast（Kappa =0.191 0）.But the result of the TTM in the breasl group was coincident with that of ultrasonograph） in median level（kappa =0.5625）.For diagnosing thyroid and breasl diseases,palpation,TTM and their consistencies with ultrasonograp） had the AUC of 0.61,0.59.0.56 and 0.57 respectively.Conclusion The consistency between TTM and B type ultrasonography in the screening of thyroid disease is low,and in breast disease is in the median level.Compared with ultrasonograpy.the diagnostic accuracy of TTM is low,its application value needs to be further studied.
出处
《疑难病杂志》
CAS
2016年第6期606-609,613,共5页
Chinese Journal of Difficult and Complicated Cases
关键词
热断层成像
甲状腺疾病
乳腺疾病
超声检查
Thermal texture maps
Thyroid disease
Breast disease
Ulrosonography
