中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
21期
1630-1633
,共4页
鄢曹鑫%罗志艳%刘学明%黄品同%莫国强%洪玉蓉%闻卿%潘敏强%翁慧芳
鄢曹鑫%囉誌豔%劉學明%黃品同%莫國彊%洪玉蓉%聞卿%潘敏彊%翁慧芳
언조흠%라지염%류학명%황품동%막국강%홍옥용%문경%반민강%옹혜방
超声检查%弹性成像技术%甲状腺肿瘤
超聲檢查%彈性成像技術%甲狀腺腫瘤
초성검사%탄성성상기술%갑상선종류
Ultrasonography%Elasticity imaging techniques%Thyroid neoplasms
目的 探讨常规超声和超声弹性成像联合评分在甲状腺良恶性结节鉴别诊断中的应用价值.方法 选取2010年12月至2011年7月在浙江大学医学院附属第二医院超声科行超声检查病例,应用常规超声和超声弹性成像联合评分法对347个甲状腺结节进行评分,常规详细记录每一个结节二维超声征象及弹性成像图,并给予赋值评分,计算每个结节的总积分,根据病变的评分值将其分类,与手术病理结果和超声引导下细针穿刺(FNAC)细胞学检查结果对照,采用ROC曲线评价超声积分法对其的诊断价值.结果 347个甲状腺结节病理诊断良性184个(良性组),恶性163个(恶性组)；根据结节的边界、纵横比、内部回声、有无微小钙化斑、声衰及内部血流情况、弹性成像评分7项参数综合而成的总积分在两组间有差异,恶性结节的积分高于良性结节；以联合评分≥4分为鉴别甲状腺良恶性结节的诊断界点,诊断灵敏度、特异度及准确性分别为84.0％,89.6％和84.9％,ROC曲线下面积为0.898.结论 常规超声和超声弹性成像联合评分有助于对甲状腺良恶性结节进行鉴别诊断,并为超声引导下FNAC提供更客观、准确的适应证.
目的 探討常規超聲和超聲彈性成像聯閤評分在甲狀腺良噁性結節鑒彆診斷中的應用價值.方法 選取2010年12月至2011年7月在浙江大學醫學院附屬第二醫院超聲科行超聲檢查病例,應用常規超聲和超聲彈性成像聯閤評分法對347箇甲狀腺結節進行評分,常規詳細記錄每一箇結節二維超聲徵象及彈性成像圖,併給予賦值評分,計算每箇結節的總積分,根據病變的評分值將其分類,與手術病理結果和超聲引導下細針穿刺(FNAC)細胞學檢查結果對照,採用ROC麯線評價超聲積分法對其的診斷價值.結果 347箇甲狀腺結節病理診斷良性184箇(良性組),噁性163箇(噁性組)；根據結節的邊界、縱橫比、內部迴聲、有無微小鈣化斑、聲衰及內部血流情況、彈性成像評分7項參數綜閤而成的總積分在兩組間有差異,噁性結節的積分高于良性結節；以聯閤評分≥4分為鑒彆甲狀腺良噁性結節的診斷界點,診斷靈敏度、特異度及準確性分彆為84.0％,89.6％和84.9％,ROC麯線下麵積為0.898.結論 常規超聲和超聲彈性成像聯閤評分有助于對甲狀腺良噁性結節進行鑒彆診斷,併為超聲引導下FNAC提供更客觀、準確的適應證.
목적 탐토상규초성화초성탄성성상연합평분재갑상선량악성결절감별진단중적응용개치.방법 선취2010년12월지2011년7월재절강대학의학원부속제이의원초성과행초성검사병례,응용상규초성화초성탄성성상연합평분법대347개갑상선결절진행평분,상규상세기록매일개결절이유초성정상급탄성성상도,병급여부치평분,계산매개결절적총적분,근거병변적평분치장기분류,여수술병리결과화초성인도하세침천자(FNAC)세포학검사결과대조,채용ROC곡선평개초성적분법대기적진단개치.결과 347개갑상선결절병리진단량성184개(량성조),악성163개(악성조)；근거결절적변계、종횡비、내부회성、유무미소개화반、성쇠급내부혈류정황、탄성성상평분7항삼수종합이성적총적분재량조간유차이,악성결절적적분고우량성결절；이연합평분≥4분위감별갑상선량악성결절적진단계점,진단령민도、특이도급준학성분별위84.0％,89.6％화84.9％,ROC곡선하면적위0.898.결론 상규초성화초성탄성성상연합평분유조우대갑상선량악성결절진행감별진단,병위초성인도하FNAC제공경객관、준학적괄응증.
Objective To explore the values of total ultrasonic scores of conventional ultrasound and ultrasound elastography in the diagnosis of thyroid nodular lesions.Methods A total of 347 thyroid nodules proved by fine-needle aspiration cytology (FNAC)and surgery underwent preoperative conventional ultrasound and ultrasound elastography.The features on gray scale,color Doppler flow imaging (CDFI) and elastogram were documented and total ultrasonic scores recorded.Results Among 347 nodules,184 nodules were benign and 163 malignant.Significant differences of total ultrasonic scores were found between thyroid carcinoma and benign nodular lesions including the parameters of nodular shape,edge,echoes,sound attenuation,psammous calcifications,internal blood flow and ultrasound elastography score.The higher the total ultrasonic scores,the more possibility of thyroid carcinoma was.By the analysis of receiver operating characteristic curve,the sensitivity,specificity and accuracy of distinguishing thyroid carcinoma from benign nodular lesions was 84.0％,89.6％ and 84.9％ if the cut-off value of total ultrasonic scores was over 4.Conclusion For the differential diagnosis of benign and malignant thyroid lesions,the total ultrasonic scores of conventional ultrasound and ultrasound elastography can offer greater values.
