超声弹性成像技术在鉴别诊断甲状旁腺增生和腺瘤中的应用价值  

The Value of Ultrasound Elastography in the Ldentification of Parathyroid Hyperplasia and Parathyroid Adenoma

作　　者：郭良云[1] 刘炜佳 刘燕娜[1] 章春泉[1] 胡震[1] 平璐依 Guo Liangyun;Liu Weijia;Liu Yanna;Zhang Chunquan;Hu Zhen;Ping Luyi(Department of Ultrasound,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学第二附属医院超声科,南昌市330006

出　　处：《中国超声医学杂志》2020年第11期976-979,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江西省基层卫生适宜技术“星火推广计划”项目(No.20198015)。

摘　　要：目的探究弹性成像应变率比值法(SR)和评分法对甲状旁腺增生和甲状旁腺瘤的鉴别诊断价值。方法选取我院收治的45例甲状旁腺病变患者(56枚病灶),于术前常规行超声弹性成像检查,并分别采用评分法和SR法对病灶进行评估。以术后病理结果为金标准,分为增生组和腺瘤组。构建ROC曲线,计算AUC及SR最佳诊断界值,计算两种方法的诊断灵敏度、特异度及准确性。结果56枚病灶中,增生组33枚,SR中位数为0.99(0.79、1.50);腺瘤组23枚,SR中位数为2.07(1.43、2.20);两者差异有统计学意义(P<0.05)。SR最佳诊断界值为1.85,即SR<1.85为甲状旁腺增生,SR≥1.85为甲状旁腺腺瘤;SR法鉴别增生和腺瘤的灵敏度、特异度、准确性分别为73.9%,84.8%,80.3%。评分法鉴别增生和腺瘤的灵敏度、特异度、准确性分别为69.6%,81.8%,76.8%。两者准确性比较差异无统计学意义(P>0.05)。SR法和评分法的AUC分别为0.814、0.798,两者差异无统计学意义(P>0.05)。结论甲状旁腺腺瘤SR值高于甲状旁腺增生,SR法和评分法均可对甲状旁腺增生和腺瘤进行鉴别,但SR法作为一种半定量方法较评分法更为客观。Objective To investigate values of ultrasonic elastic strain ratio(SR)and scoring method in differentiating parathyroid hyperplasia and parathyroid adenoma.Methods A total of 56 lesions from 45 patients with parathyroid masses were performed ultrasound elastography.SR and scoring methods were used to evaluate the parathyroid masses.According to the postoperative pathological results as the gold standard,it was divided into hyperplasia group and adenoma group.Receiver operating characteristic(ROC)of SR and scoring method were portrayed,the cut-off points and the area under curve(AUC)were calculated.The sensitivity,specificity,accuracy of SR and scoring method were calculated.Results Hyperplasia group(n=33),the median SR was 0.99(0.79、1.50);adenoma group(n=23),the median SR was 2.07(1.43,2.20);the difference is statistically significant(P<0.05).The best diagnostic limit of SR was 1.85.The sensitivity,specificity and accuracy of SR and scoring method in diagnosing parathyroid masses were 73.9%,84.8%,80.3%and 69.6%,81.8%,76.8%.There was no significant differ in accuracy(P>0.05).The AUC of the two method were 0.814 and 0.798,the difference is statistically insignificant(P>0.05).Conclusions SR value of parathyroid adenoma is higher than hyperplasia.Both SR and scoring method can identify parathyroid hyperplasia and adenoma,but SR is more objective.

关 键 词：超声弹性成像技术 应变率比值法 评分法 甲状旁腺增生 甲状旁腺腺瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R582[医药卫生—诊断学]