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目的探讨超声弹性成像(UE)技术在甲状腺良、恶性结节鉴别诊断中的应用价值。方法 97例患者共121个甲状腺结节行UE检查并评分,计算结节UE图与二维声像图的面积比值(AR),绘制受试者工作特征(ROC)曲线,确定AR预测甲状腺恶性结节的最佳界点。结果甲状腺恶性结节UE评分≥4分比例高于良性结节(85.4%vs.6.8%)(P<0.01),以UE评分≥4分诊断甲状腺恶性结节敏感度为85.41%和特异度为93.15%。甲状腺恶性结节的AR大于良性结节(1.98±0.36vs.1.25±0.18)(P<0.01)。ROC曲线下面积为0.907,以AR≥1.46为最佳界点时诊断甲状腺恶性结节的敏感度为89.50%和特异度为87.67%。结论 UE技术在甲状腺良、恶性结节鉴别诊断中具有较高的应用价值,值得临床推广。
Objective To investigate the value of ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid nodules. Methods A total of 121 thyroid nodules were examined by the UE in 97 patients and scored. The area ratio (AR) between the UE and the two-dimensional sonography was calculated and the receiver operating characteristic (ROC) curve was drawn to determine the predictive value of AR in predicting the thyroid malignancy The best nodal point. Results The proportion of patients with malignant thyroid nodules (≥4) was higher than that of benign nodules (85.4% vs.6.8%) (P <0.01). The sensitivity and specificity of UE with grade 4 or higher were 85.41% 93.15%. The AR of malignant thyroid nodules was higher than that of benign nodules (1.98 ± 0.36 vs 1.25 ± 0.18) (P <0.01). The area under the ROC curve was 0.907. The sensitivity and specificity of diagnosing thyroid malignant nodules with AR≥1.46 as the best cutoff point were 89.50% and 87.67% respectively. Conclusion The UE technique has high value in the differential diagnosis of benign and malignant thyroid nodules and is worthy of clinical promotion.