CAJ | 학술논문

目的评价并筛选鉴别甲状腺结节的灰阶和彩色多普勒超声特征指标.方法手术前观察95例患者共104个甲状腺结节(良性结节53个,恶性51个)的灰阶和彩色多普勒特征,根据其恶性可能性评分;利用Logistic逐步回归分析筛选出主要独立诊断指标并建立诊断恶性可能性的公式.结果 53个良性结节包括44个结节性甲状腺肿、7个腺瘤、1个缝线肉芽肿和1个桥本病,51个恶性结节包括47个乳头状癌、3个髓样癌、1个转移癌.诊断恶性结节的有意义指标包括形态、边界、边缘特征、晕、内部回声、回声水平、均匀性、钙化、血管走行、血流局部丰富.经过二变量Logistic逐步回归,得出以下方程:恶性可能性=1/1+e-z其中z=-7.44+1.30×晕+1.05×钙化+1.5×血管走行.当甲状腺结节无晕、具有微小钙化且血管走行不规则时恶性危险可能性为0.99,当有完整晕、无钙化和血流规则时恶性危险性为0.02.结论晕、钙化及血管走行是灰阶及彩色多普勒超声预测甲状腺恶性结节的三个独立特征指标.
목적 평개병사선감별갑상선결절적회계화채색다보륵초성특정지표.방법 수술전관찰95례환자공104개갑상선결절(량성결절53개,악성51개)적회계화채색다보륵특정,근거기악성가능성평분;이용Logistic축보회귀분석사선출주요독립진단지표병건립진단악성가능성적공식.결과 53개량성결절포괄44개결절성갑상선종、7개선류、1개봉선육아종화1개교본병,51개악성결절포괄47개유두상암、3개수양암、1개전이암.진단악성결절적유의의지표포괄형태、변계、변연특정、훈、내부회성、회성수평、균균성、개화、혈관주행、혈류국부봉부.경과이변량Logistic축보회귀,득출이하방정:악성가능성=1/1+e-z기중z=-7.44+1.30×훈+1.05×개화+1.5×혈관주행.당갑상선결절무훈、구유미소개화차혈관주행불규칙시악성위험가능성위0.99,당유완정훈、무개화화혈류규칙시악성위험성위0.02.결론 훈、개화급혈관주행시회계급채색다보륵초성예측갑상선악성결절적삼개독립특정지표.
Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.