超声弹性成像应变率中的ROIA值与弹性评分诊断甲状腺结节的价值比较  

Value of ROI A value in strain ratio and elasticity scores in differential diagnosis of thyroid nodules using ultrasonic elastography

作　　者：安秀艳[1] 丛淑珍[1] 钱隽[1] 郭玉萍[1] 周立峰[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：《南方医科大学学报》2013年第3期454-457,共4页Journal of Southern Medical University

基　　金：广东省科技计划项目(20101096)

摘　　要：目的探讨弹性应变率中的ROI A值在鉴别诊断甲状腺良恶性结节的价值,并与弹性评分作对比。方法对124例患者共166个甲状腺结节术前均行弹性成像检查,获得弹性评分与弹性应变率中的ROI A值,采用ROC曲线评价ROI A值对甲状腺结节的诊断价值并寻找其最佳诊断界点,将ROI A值、弹性评分及两者联合诊断结果分别与病理结果对照。结果 ROI A值在鉴别甲状腺良恶性结节的ROC曲线下面积(Az)为0.825,ROI A值最佳诊断界点为0.00165,ROI A值、弹性评分、两者联合诊断甲状腺结节的敏感性、特异性、准确性、比数比分别为82.93%、72.80%、75.30%、13.0;87.80%、80.00%、81.93%、28.8;73.17%、91.20%、86.75%、32.1。联合诊断的比数比最高,联合诊断准确性显著高于ROI A值(χ2=19.31,P<0.05)及弹性评分(χ2=12.03,P<0.05)。结论 ROI A值在鉴别甲状腺良恶性结节上有中等诊断价值,有一定临床实用性,与弹性评分联合诊断有助于提高诊断准确性。Objective To study the value of ROI A value in the strain ratio and the elasticity scores by the 4-score system in ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules. Methods A total of 124 patients with 166 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the elasticity score and the ROI A value in strain ratio. Receiver operating characteristic （ROC） curves were used to assess the diagnostic value of ROI A value, and the best cutoff point was determined. The results of diagnosis based on ROI A value, elasticity scores, and their combination were compared with the results of pathological diagnosis. Results The area under the ROC curve （Az） of ROI A value for differentiating benign and malignant thyroid nodules was 0.825. The best diagnostic cut-off point of ROI A value was 0.00165. In differentiating benign and malignant thyroid nodules, the sensitivity, specificity, accuracy and odds ratio were 82.93%, 72.80%, 75.30%, and 13.0 for ROI A value, 87.80%, 80.00%, 81.93%, and 28.8 for the elasticity scores, and 73.17%, 91.20%, 86.75%, and 32.1 for their combination, respectively. The odds ratio of the combined diagnosis was the highest, and the accuracy of the combined diagnosis was significantly higher than that of ROI A value （χ2=19.31, V〈0.05） and the elasticity scores （χ2=12.03, P〈0.05）. Conclusion ROI A value has moderate diagnostic value and clinical practicability in differentiating thyroid nodules. The diagnostic accuracy of ROI A value can be improved by combining with the elasticity scores.

关 键 词：甲状腺结节 超声检查 弹性成像 应变率 

分 类 号：R445.1[医药卫生—影像医学与核医学]