超声弹性分级法鉴别诊断甲状腺实性结节的良恶性  

Ultrasound elastic stiffness grade in differential diagnosis of benign and malignant thyroid solid nodules

作　　者：刘利平[1] 杨婧 崔荣荣[1] 张扬[1] 刘静静[1] 张炎晶[1] 赵育芳[1] 

机构地区：[1]山西医科大学第一医院超声科,山西太原030001 [2]太原市急救中心医务科,山西太原030007

出　　处：《中国介入影像与治疗学》2015年第12期756-759,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：山西省回国留学人员科研资助项目(2014-073);山西省高校131领军人才工程优秀拔尖人才支持基金(2013-404)

摘　　要：目的探讨超声弹性成像分级法在甲状腺实性结节良恶性鉴别诊断中的价值及不同医师之间的诊断一致性。方法 72例(89个)甲状腺实性结节患者接受超声检查,由2名医师以超声弹性成像分级法进行分级,并将分级结果与术后病理结果进行对比研究。结果医师1以超声弹性成像分级法诊断恶性甲状腺结节的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为82.93%(34/41)、83.33%(40/48)、83.15%(74/89)、80.95%(34/42)、85.11%(40/47);医师2分别为85.37%(35/41)、81.25%(39/48)、83.15%(74/89)、79.55%(35/44)、86.67%(39/45)。两名医师诊断一致率为95.55%,Kappa=0.752。结论超声弹性成像分级法对甲状腺实性结节良恶性鉴别诊断具有较好的应用价值,不同医生独立完成弹性成像的一致性较好。Objective To study the value of real-time ultrasonic elastography grade and different physician consistence in diagnosis of benign and malignant thyroid solid nodules. Methods Totally 89 thyroid solid nodules in 72 patients under- went ultrasonography and were graded with elastography classification by two doctors respectively. Classification results were compared with pathology results. Results The sensitivity, specificity, accuracy, positive predictive and negative pre- dictive value of the two doctors in diagnosis of malignant thyroid solid nodules with elastic stiffness grading method were 82.93% （34/41）, 83.33%（40/48）, 83.15%（74/89）, 80.95% （34/42）, 85.11% （40/47） and 85.37% （35/41）, 81.25% （39/48）, 83.15% （74/89）, 79.55% （35/44）, 86.67% （39/45）. The diagnosis consistence rate of two physi- cians was 95.55%, Kappa=0. 752. Conclusion Elastography has a high value in differential diagnosis of benign and ma- lignant thyroid solid nodules. Elastography achieve a good consistence performed by different physicians.

关 键 词：甲状腺结节 弹性成像 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]