CAJ | 학술논문

目的探讨超声弹性成像弹性评分法及顺应性比值法在甲状腺实性结节鉴别诊断中的应用价值.方法对69例患者的86个甲状腺实性结节根据术后病理结果分为良性组及恶性组,分别对两组的超声弹性图像评分及顺应性比值进行回顾性分析,与术后病理结果对比,计算弹性评分法及顺应性比值法诊断的敏感性、特异性及准确性;绘制弹性评分法及顺应性比值法的受试者工作特征曲线(ROC曲线),选取最佳诊断界点.结果 86个甲状腺结节中,良性组甲状腺结节共67个,结节直径(2.05±0.21)cm;恶性组甲状腺结节共19个,结节直径(1.62±0.12)cm.良性组及恶性组结节直径比较,差异无统计学意义(t=-1.736,P＞0.05).良性组与恶性组间弹性评分(中位数分别为2、3分)及顺应性比值(中位数分别为1.66、3.97)比较,差异有统计学意义(Z值分别为-5.290、-5.450,P均＜0.05).以弹性评分≥3分为鉴别甲状腺良、恶性的诊断界点,诊断敏感性、特异性及准确性分别为84.2%(16/19)、86.6%(58/67)和86.0%(74/86),ROC曲线下面积为0.854;以顺应性比值≥2.50为鉴别甲状腺良、恶性的诊断界点,诊断敏感性、特异性及准确性分别为89.4%(17/19)、86.6%(58/67)和87.2%(75/86),ROC曲线下面积为0.911.结论超声弹性成像弹性评分法及顺应性比值法均有助于甲状腺良、恶性结节的鉴别诊断,在临床具有较高的应用价值.
목적 탐토초성탄성성상탄성평분법급순응성비치법재갑상선실성결절감별진단중적응용개치.방법 대69례환자적86개갑상선실성결절근거술후병리결과분위량성조급악성조,분별대량조적초성탄성도상평분급순응성비치진행회고성분석,여술후병리결과대비,계산탄성평분법급순응성비치법진단적민감성、특이성급준학성;회제탄성평분법급순응성비치법적수시자공작특정곡선(ROC곡선),선취최가진단계점.결과 86개갑상선결절중,량성조갑상선결절공67개,결절직경(2.05±0.21)cm;악성조갑상선결절공19개,결절직경(1.62±0.12)cm.량성조급악성조결절직경비교,차이무통계학의의(t=-1.736,P＞0.05).량성조여악성조간탄성평분(중위수분별위2、3분)급순응성비치(중위수분별위1.66、3.97)비교,차이유통계학의의(Z치분별위-5.290、-5.450,P균＜0.05).이탄성평분≥3분위감별갑상선량、악성적진단계점,진단민감성、특이성급준학성분별위84.2%(16/19)、86.6%(58/67)화86.0%(74/86),ROC곡선하면적위0.854;이순응성비치≥2.50위감별갑상선량、악성적진단계점,진단민감성、특이성급준학성분별위89.4%(17/19)、86.6%(58/67)화87.2%(75/86),ROC곡선하면적위0.911.결론 초성탄성성상탄성평분법급순응성비치법균유조우갑상선량、악성결절적감별진단,재림상구유교고적응용개치.
Objective To evaluate the value of ultrasound elastography score and strain ratio index in the differential diagnosis of thyroid solid nodules. Methods Eighty-six thyroid solid nodules of 69 patients were divided into 2 groups based on their pathologic results: benign nodules group and malignant nodules group.Compared with pathological results, each thyroid solid nodules' elastographic scores and strain ratio index were respectively analyzed. The sensitivity, specificity and accuracy of elasticity score and strain ratio index were calctlated.The receiver operator characteristic (ROC) curves were drawn according to the results, to choose the best cut-off value.Results There were 67 nodules in benign nodules group and 19 nodules in malignant nodules group. The diameter of benign nodules was (2.05 ± 0.21)cm, malignant nodules was (1.62 ± 0.12)cm. There were no significant differences in the elasticity score and strain ratio index between benign and malignant nodules(t= - 1.736, P ＞ 0.05). Malignant lesions had a higher score and strain ratio index(median 3, 3.97, respectively) than benign ones(median 2, 1.66,respectively, Z = - 5.290, - 5.450, all P ＜ 0.05). If the cut-off value of the elastographic scores was equal or more than 3, the sensitivity, specificity and accuracy were 84.2%(16/19) ,86.6%(58/67) and 86.0%(74/86), respectively,with an area under ROC curve of 0.854. If the cut-off value of the strain ratio index was equal or more than 2.50,the sensitivity, specificity and accuracy were 89.4%(17/19),86.6%(58/67) and 87.2%(75/86), respectively, with an area under ROC curve of 0.911. Conclusion Elasticity score and strain ratio index are helpful in differentiating benign and malignant lesions of thyroid with high clinical value.