超声造影检查对早期甲状腺单发结节良恶性的鉴别诊断价值  

Value of Contrast-enhanced Ultrasonography in the Differential Diagnosis of Benign and Malignant Thyroid Solitary Nodules

作　　者：杨舟[1] 宋宏[1] 郭鹏[1] 郭利清[1] 房秀霞[1] 

机构地区：[1]内蒙古医科大学附属医院超声科,内蒙古呼和浩特010050

出　　处：《现代生物医学进展》2017年第3期489-491,499,共4页Progress in Modern Biomedicine

基　　金：内蒙古自治区科技厅面上项目(2013MS1139)

摘　　要：目的:建立以甲状腺单发结节超声诊断为变量的回归模型,分析比较超声造影与常规超声检查对甲状腺单发结节良恶性的鉴别诊断价值。方法:选择来我院就诊的甲状腺单发结节患者274例,让所有患者均接受常规超声检查和超声造影检查,并手术后进行病理诊断,建立相应回归模型,评价超声造影对甲状腺单发性良恶性结节的鉴别诊断价值,为临床检查及治疗提供参考。结果:超声造影检查的良恶性检出率均优于常规超声检查。超声造影检查良性结节检出率为65.69%,恶性检出率为34.31%,敏感度96.70%,特异度95.65%,准确率96.35%,均优于常规超声检查。Logistic回归分析显示,钙化、达峰时间、增强程度及最大灌注强度以上四项特征出现的越多,待测的甲状腺结节越有可能是恶性结节。结论:超声造影对良、恶性甲状腺单发结节的鉴别具有重要的临床诊断意义。Objective： To analyze the ultrasound image characteristics of thyroid solitary nodules through establishing regression model of the ultrasonic diagnosis of thyroid solitary nodules which was set as the variable of the regression model,and to discuss the value of contrast-enhanced ultrasound in differential diagnosis of thyroid solitary nodules. Methods： 274 cases were selected for treatment of solitary thyroid nodules in our hospital. All the patients accepted routine ultrasound examination and ultrasonic hysterography. Then the corresponding regression model was established,and analyzed with Logistic regression analysis so as to compare the variables. And the contrast-enhanced ultrasound in the differential diagnosis of malignant and benign thyroid solitary nodules was discused. Results： The detection rate of benign and malignant of contrast-enhanced ultrasound was better than that of conventional ultrasound. The detection rate of benign nodules was 65.69%,the detection rate was 34.31%,the sensitivity was 96.70%,the specificity was 95.65%,and the accuracy rate was 96.35%,which was better than that of routine ultrasound examination. The Logistic regression analysis showed that the peak time,calcification,enhancement degree and the maximum perfusion intensity above all the four variables were statistically significant on the diagnosis of solitary thyroid nodules. The more the four items appear in thyroid nodules,the more likely it is to be a malignant nodule.Conclusion： The contrast-enhanced ultrasound in the differential diagnosis of malignant and benign thyroid solitary nodules is very big.

关 键 词：甲状腺单发结节 超声造影 LOGISTIC回归分析 

分 类 号：R736.1[医药卫生—肿瘤]