CAJ | 학술논문

目的建立以甲状腺微小结节超声诊断特征为变量的Logistic回归模型,评价二维灰阶超声、彩色多普勒超声、超声弹性成像及超声造影成像模式在甲状腺微小实性结节中的诊断价值.方法回顾性分析经手术病理证实的130例最大病灶直径≤1.0 cm且无甲状腺弥漫性病变患者的临床资料,共142个病灶,其中良性68个,恶性74个,对结节各项超声诊断指标采用多因素回归分析方法建立Logistic回归模型,绘制ROC曲线并计算曲线下面积.结果 Logistic逐步回归分析显示结节内部微钙化、纵横比、造影晚期回声及弹性评分4个变量进入回归模型,该Logistic回归模型对最大直径≤1.0 cm的甲状腺结节良恶性预测的正确率为92.1％(129/142),ROC曲线下面积为0.944.结论二维和彩色多普勒超声结合组织弹性成像技术及超声造影技术在最大直径≤1.0 cm的甲状腺良恶性结节的鉴别诊断中具有较高的临床应用价值.
목적 건립이갑상선미소결절초성진단특정위변량적Logistic회귀모형,평개이유회계초성、채색다보륵초성、초성탄성성상급초성조영성상모식재갑상선미소실성결절중적진단개치.방법 회고성분석경수술병리증실적130례최대병조직경≤1.0 cm차무갑상선미만성병변환자적림상자료,공142개병조,기중량성68개,악성74개,대결절각항초성진단지표채용다인소회귀분석방법건립Logistic회귀모형,회제ROC곡선병계산곡선하면적.결과 Logistic축보회귀분석현시결절내부미개화、종횡비、조영만기회성급탄성평분4개변량진입회귀모형,해Logistic회귀모형대최대직경≤1.0 cm적갑상선결절량악성예측적정학솔위92.1％(129/142),ROC곡선하면적위0.944.결론 이유화채색다보륵초성결합조직탄성성상기술급초성조영기술재최대직경≤1.0 cm적갑상선량악성결절적감별진단중구유교고적림상응용개치.
Objective To apply the binary Logistic regression model and evaluate the value of grey scale ultrasonography(US),ultrasond elastography(UE) and contrast-enhanced ultrasound(CEUS).Methods US,UE and CEUS were performed in 130 patients with 142 solid thyroid micronodules (the largest diameter less than 10 mm).Pathology was followed up as golden diagnosis criteria.A Logistic model on the basis of ultrasonographic features was obtained.A receiver operating characteristic(ROC) curve was used to assess the performance of Logistic model.Results Four ultrasonic indexes were finally entered into the Logistic regression model including microcalcification,acpect ratio,advanced CEUS mode and elasticity score.The percentage correction of prediction was 92.1％ (129/142),the area under the ROC curve was 0.944.Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid thyroid micronodules by ultrasonography,and select out the valuable indexes for differential diagnosis.