CAJ | 학술논문

目的建立以甲状腺结节超声诊断特征为变量的Logistic回归模型,评价常规超声及剪切波弹性成像在甲状腺结节良恶性鉴别诊断中的价值.方法对在我院接受甲状腺手术或甲状腺结节活检的193例患者进行常规超声和剪切波弹性成像检查.以手术病理或活检病理为金标准.结果纳入研究的235个结节中,157个为良性结节,78个为恶性结节.1 57个良性结节的平均杨氏模量为(28.7±16.7) kPa,78个恶性结节的平均杨氏模量为(66.8±44.6)kPa(P=0.000).杨氏模量值诊断结节良恶性的ROC曲线下面积为0.802,最优诊断界点为39.2 kPa.利用Logistic回归分析评价各个超声特征,筛选出回声类型、纵横比、微小钙化及杨氏模量等4个在甲状腺单发结节良恶性鉴别诊断中有统计学意义的特征变量,其中杨氏模量的优势比(6.211)远高于其他变量.结论剪切波弹性成像测得的杨氏模量值能定量评价结节硬度,较常规超声检查更有助于甲状腺结节的良恶性诊断.
목적 건립이갑상선결절초성진단특정위변량적Logistic회귀모형,평개상규초성급전절파탄성성상재갑상선결절량악성감별진단중적개치.방법 대재아원접수갑상선수술혹갑상선결절활검적193례환자진행상규초성화전절파탄성성상검사.이수술병리혹활검병리위금표준.결과 납입연구적235개결절중,157개위량성결절,78개위악성결절.1 57개량성결절적평균양씨모량위(28.7±16.7) kPa,78개악성결절적평균양씨모량위(66.8±44.6)kPa(P=0.000).양씨모량치진단결절량악성적ROC곡선하면적위0.802,최우진단계점위39.2 kPa.이용Logistic회귀분석평개각개초성특정,사선출회성류형、종횡비、미소개화급양씨모량등4개재갑상선단발결절량악성감별진단중유통계학의의적특정변량,기중양씨모량적우세비(6.211)원고우기타변량.결론 전절파탄성성상측득적양씨모량치능정량평개결절경도,교상규초성검사경유조우갑상선결절적량악성진단.
Objective To contribute the binary Logistic regression model to evaluate conventional ultrasound and shear wave elastography (SWE) on differentiating malignant thyroid nodules.Methods A total of 193 patients scheduled to undergo core-biopsy or surgery of thyroid nodule were enrolled.Both conventional ultrasound and SWE were performed,which were then correlated with pathological results.Results There were 157 benign thyroid nodules and 78 malignant thyroid nodules.The mean of SWE value of benign nodules was (28.7 ± 16.7)kPa,and it was (66.8 ± 44.6)kPa in malignant nodules (P =0.000).The area under the operator characteristic curve (AUC) was 0.802,with the optimal cut-off value of 39.2 kPa.Four ultrasound characteristics finally entering the multivariate Logistic model were echogenicity,aspect ratio,microcalcification and SWE values.The odd ratio of SWE value (6.211) was higher than all the conventional ultrasound characteristics.Conclusions SWE provides quantitative information about the tissue stiffness,which plays a more important role in discriminating malignant thyroid nodules than conventional ultrasound characteristics.