甲状腺结节内部动脉阻力指数差异鉴别诊断结节良恶性  

Use of arterial resistance index deviation in differentiation diagnosis of benign and malignant thyroid nodules

作　　者：陈继 龚心德 陈少雷 尹慧 CHEN Ji;GONG Xinde;CHEN Shaolei;YIN Hui(Department of Ultrasound Diagnostics,Affiliated Dongfeng General Hospital,Hubei Medical College,Shiyan 442008,P.R.China)

机构地区：[1]湖北医药学院附属东风医院超声诊断科,湖北十堰442008

出　　处：《医学影像学杂志》2019年第4期557-560,共4页Journal of Medical Imaging

基　　金：湖北省十堰市科技局资助项目(编号:15Y51)

摘　　要：目的评估结节内部动脉阻力指数与甲状腺上动脉阻力指数的差异对甲状腺结节良恶性的鉴别诊断价值。方法 100例甲状腺结节患者,共129个结节,所有患者均接受甲状腺功能检查,超声检查及外科手术治疗。脉冲波多普勒测量甲状腺结节内部动脉及结节同侧甲状腺上动脉阻力指数(RIN、RISTA),计算|RIN-RISTA|及ΔRI(ΔRI=|RIN-RISTA|/RISTA)。根据术后病理诊断将结节分为良性结节组(n=76)和恶性结节组(n=53),对|RIN-RISTA|、ΔRI及RIN行组间对比;并绘制|RIN-RISTA|、ΔRI及RIN诊断甲状腺恶性结节的受试者工作曲线(ROC)。结果良性结节组与恶性结节组间,|RIN-RISTA|及ΔRI差异分别具有显著统计学意义(P=0.000),|RIN-RISTA|、ΔRI在恶性结节组均高于良性结节组;以|RIN-RISTA|=0.0950为诊断截断值时,诊断敏感性和特异性分别为83.0%、63.2%;以ΔRI=0.1794为诊断截断值时,诊断敏感性和特异性分别为79.2%、68.4%。结论 |RIN-RISTA|及ΔRI是鉴别甲状腺结节良恶性的良好指标。Objective To evaluate the value of arterial resistance index deviation in differentiation diagnosis of benign and malignant thyroid nodules. Methods 100 patients with 129 thyroid nodules, thyroid function tests, ultrasonography and surgery were received. Resistance index of thyroid nodules interior artery (RIN) and ipsilateral superior thyroid artery (RISTA) were measured by spectral Doppler pre-surgery. We calculated the variability of RIN to RISTA |RIN-RISTA| and ΔRI(ΔRI=|RIN-RISTA|/RISTA). The nodules were divided into benign group (n=76) and malignant group (n=53) by postoperative pathological diagnosis. We compared of |RIN-RISTA|,ΔRI and RIN between the groups respectively and the receiver operating characteristic curve (ROC) for malignant thyroid nodule diagnosis via ΔRI,|RIN-RISTA| and RIN were analyzed. Results The difference of ΔRI and |RIN-RISTA| between benign group and malignant group is statistically significant ( P =0.000), respectively. Both ΔRI and |RIN-RISTA| in malignant group are higher than that in benign group. When the value of |RIN-RISTA| in diagnostic cutoff point is 0.0950, the sensitivity and specificity are 83.0% and 63.2% respectively. When the value of ΔRI in diagnostic cutoff point is 0.1794, the sensitivity and specificity are 79.2% and 68.4%. Conclusion |RIN-RISTA| and ΔRI are good indices to differentiate benign and malignant thyroid nodules.

关 键 词：甲状腺 良性结节 恶性结节 阻力指数差异 

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