对比研究超声弹性应变率与常规超声鉴别甲状腺结节的价值  

Comparative study of strain ratio in ultrasonic elestography and gray-scale ultrasonography for differential diagnosis of thyroid nodules

作　　者：安秀艳[1] 丛淑珍[1] 钱隽[1] 赵晓虹[1] 甘科红[1] 梁婷[2] 

机构地区：[1]广东省医学科学院广东省人民医院超声科,广东广州510080 [2]南方医科大学,广东广州510515

出　　处：《中国临床医学影像杂志》2013年第2期85-87,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:比较超声弹性应变率与常规超声对甲状腺结节的鉴别诊断价值。方法:对165例患者的196个甲状腺结节进行常规超声及弹性成像检查,常规超声采用半定量评分方法判断结节的性质,计算弹性应变率并构建ROC曲线,获得最佳诊断界值,以术后病理结果为金标准,比较弹性应变率、常规超声及联合诊断的诊断价值。结果:弹性应变率诊断甲状腺良恶性结节的ROC曲线下面积(Az)为0.826,最佳诊断界值为2.51,弹性应变率诊断敏感性、特异性、准确性分别为81.63%、72.79%、75.00%;常规超声诊断敏感性、特异性、准确性分别为77.55%、74.83%、75.51%;联合诊断的敏感性、特异性、准确性分别为73.47%、88.43%、84.69%。弹性应变率与常规超声准确性比较无统计学意义(χ2=1.45,P>0.05)。联合诊断的准确性明显高于弹性应变率(χ2=20.48,P<0.05)与常规超声(χ2=14.70,P<0.05)。结论:弹性应变率在鉴别诊断甲状腺良恶性结节方面有中等价值,与常规超声联合诊断对准确性有明显提高。Objective： To compare the value of strain ratio in ultrasonic elestography and gray-scale ultrasonography in differentiating benign and malignant thyroid nodules. Methods： A total of 165 patients with 196 thyroid nodules underwent conventional uhrasonography and elastography. The strain ratio of nodules were calculated. Receiver operating characteristic （ROC） curves were used to assess the diagnostic value of strain ratio. The sensitivity, specificity and accuracy were compared with gray-scale ultrasonography. Results： The area under the ROC curve（Az） of the strain ratio was 0.826. The strain ratio of 2.51 was the best diagnostic cut-off point. The sensitivity, specificity and accuracy of strain ratio were 81.63%, 72.79% and 75.00%. The sensitivity, specificity and accuracy of gray-scale ultrasonography were 77.55%, 74.83% and 75.51%. The sensitivity, specificity and accuracy of combined diagnosis were 73.47%, 88.43% and 84.69%, respectively. The difference between strain ratio and gray-scale ultrasonography was not signifieant（X^2=1.45, P〉0.05）. The accuracy of combined diagnosis was higher than that of strain ratio（X^2=20.48, P〈0.05） or gray-scale ultrasonography（X^2=14.70, P〈0.05） alone. Conclusion： Strain ratio has moderate degree of diagnostic value in differentiating the benign and malignant thyroid nodules. Combination of strain ratio and gray scale uhrasonography can increase diagnostic accuracy significantly.

关 键 词：甲状腺结节 超声检查 多普勒 彩色 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]