医学研究生学报
醫學研究生學報
의학연구생학보
Journal of Medical Postgraduates
2015年
10期
1071-1074
,共4页
甲状腺影像报告与评分系统%弹性成像%甲状腺结节%甲状腺超声检查
甲狀腺影像報告與評分繫統%彈性成像%甲狀腺結節%甲狀腺超聲檢查
갑상선영상보고여평분계통%탄성성상%갑상선결절%갑상선초성검사
Thyroid imaging reporting and data system%Ultrasound elastography%Thyroid nodule%thyroid ultrasonography
目的 高频超声的广泛应用使得甲状腺结节的检出率逐年增加. 文中旨在探讨常规超声、弹性成像及两者联合应用对甲状腺良恶性结节的诊断价值. 方法 回顾性分析南京军区南京总医院2014年9月至2015 年8月105例甲状腺结节患者的160枚甲状腺结节超声图像,通过绘制甲状腺影像报告与评分系统( thyroid imaging reporting and data system , TI-RADS)评分、弹性评分和联合评分ROC曲线,计算并比较曲线下面积,选取合适截断点,分别计算3种方法的诊断效能,并与病理结果进行Kappa一致性检验. 结果 联合评分的ROC曲线的曲线下面积(0.930,95%CI:0.890 ~0.969)大于TI-RADS评分(0.855,95%CI:0.794~0.915)和弹性评分(0.845,95% CI:0.780~0.909),差异均有统计学意义(P<0.05).以TI-RADS≥4 分,弹性评分≥3 分及联合评分≥7 分为诊断甲状腺恶性结节的界点,联合评分的特异度、阳性预测值(94.3%、91.7%)均高于TI-RDAS评分(78.4%、84.7%)和弹性评分(81.8%、78.7%). 联合评分的敏感度低于弹性评分和TI-RDAS评分,而其NPV高于TI-RDAS评分,低于弹性评分. 联合评分的Kappa值(0.718, 95%CI:0.610~0.826)均高于TI-RDAS评分(0.586, 95%CI:0.461~0.711)和弹性评分(0.635, 95%CI:0.515~0.755). 结论 常规超声与弹性成像相互补充,联合评分较单一检查方法具有更高的诊断价值.
目的 高頻超聲的廣汎應用使得甲狀腺結節的檢齣率逐年增加. 文中旨在探討常規超聲、彈性成像及兩者聯閤應用對甲狀腺良噁性結節的診斷價值. 方法 迴顧性分析南京軍區南京總醫院2014年9月至2015 年8月105例甲狀腺結節患者的160枚甲狀腺結節超聲圖像,通過繪製甲狀腺影像報告與評分繫統( thyroid imaging reporting and data system , TI-RADS)評分、彈性評分和聯閤評分ROC麯線,計算併比較麯線下麵積,選取閤適截斷點,分彆計算3種方法的診斷效能,併與病理結果進行Kappa一緻性檢驗. 結果 聯閤評分的ROC麯線的麯線下麵積(0.930,95%CI:0.890 ~0.969)大于TI-RADS評分(0.855,95%CI:0.794~0.915)和彈性評分(0.845,95% CI:0.780~0.909),差異均有統計學意義(P<0.05).以TI-RADS≥4 分,彈性評分≥3 分及聯閤評分≥7 分為診斷甲狀腺噁性結節的界點,聯閤評分的特異度、暘性預測值(94.3%、91.7%)均高于TI-RDAS評分(78.4%、84.7%)和彈性評分(81.8%、78.7%). 聯閤評分的敏感度低于彈性評分和TI-RDAS評分,而其NPV高于TI-RDAS評分,低于彈性評分. 聯閤評分的Kappa值(0.718, 95%CI:0.610~0.826)均高于TI-RDAS評分(0.586, 95%CI:0.461~0.711)和彈性評分(0.635, 95%CI:0.515~0.755). 結論 常規超聲與彈性成像相互補充,聯閤評分較單一檢查方法具有更高的診斷價值.
목적 고빈초성적엄범응용사득갑상선결절적검출솔축년증가. 문중지재탐토상규초성、탄성성상급량자연합응용대갑상선량악성결절적진단개치. 방법 회고성분석남경군구남경총의원2014년9월지2015 년8월105례갑상선결절환자적160매갑상선결절초성도상,통과회제갑상선영상보고여평분계통( thyroid imaging reporting and data system , TI-RADS)평분、탄성평분화연합평분ROC곡선,계산병비교곡선하면적,선취합괄절단점,분별계산3충방법적진단효능,병여병리결과진행Kappa일치성검험. 결과 연합평분적ROC곡선적곡선하면적(0.930,95%CI:0.890 ~0.969)대우TI-RADS평분(0.855,95%CI:0.794~0.915)화탄성평분(0.845,95% CI:0.780~0.909),차이균유통계학의의(P<0.05).이TI-RADS≥4 분,탄성평분≥3 분급연합평분≥7 분위진단갑상선악성결절적계점,연합평분적특이도、양성예측치(94.3%、91.7%)균고우TI-RDAS평분(78.4%、84.7%)화탄성평분(81.8%、78.7%). 연합평분적민감도저우탄성평분화TI-RDAS평분,이기NPV고우TI-RDAS평분,저우탄성평분. 연합평분적Kappa치(0.718, 95%CI:0.610~0.826)균고우TI-RDAS평분(0.586, 95%CI:0.461~0.711)화탄성평분(0.635, 95%CI:0.515~0.755). 결론 상규초성여탄성성상상호보충,연합평분교단일검사방법구유경고적진단개치.
Objective The increased use of high-resolution ultrasound (US) for thyroid disease has markedly increased the detection rate of nonpalpable thyroid nodules .The objective of this study was to investigate the diagnostic value of conventional ultrasonography, ultrasonic elastography(UE) and combined application of both in the differential diagnosis of thyroid nodules. Methods A retrospective analysis was made on 105 patients with 160 histologically proved thyroid nodules from September 2014 and August 2015 in our hospital.The receiver operating characteristic ( ROC) curve analysis was made on Thyroid Imaging Repor-ting and Data System ( TI-RADS) score, elastography score and the score of combined application.The area under curve ( AUC) was calculated and compared to select the best cut-off value in order to work out the respective diagnostic efficacy of 3 methods and Kappa consistence check with pathologic results . Results In ROC curve analysis, AUC of combination score(0.930, 95%CI:0.890-0.969) was higher than those of TI-RADS score(0.855, 95%CI:0.794-0.915) and elasticity score(0.845, 95%CI:0.780-0.909), and the difference was statistically significant (Z=2.20, 2.03, P<0.05) .Taking TI-RADS score≥4, elastography score≥3, and combination score≥7 as the limitation to diagnose ma-lignant thyroid nodules, the specificity and PPV of combination score(94.3%, 95%CI:0.867-0.979;91.7%, 95%CI:0.809-0.969) were higher than those of TI-RADS score(78.4%, 95%CI:0.681-0.862;84.7%, 95%CI:0.692-0.886) and e-lasticity score(81.8%, 95%CI:0.719-0.889;78.7%,95%CI:0.674-0.870).Kappa value of combination score(0.718, 95%CI:0.610-0.826) was higher than that of TI-RADS score(0.586, 95%CI:0.461-0.711) and elasticity score(0.635, 95%CI:0.515-0.755). Conclusion Conventional ultrasonography and UE are mutual complementation, and the application of conventional ultrasonography combined with UE has higher value than single examination in the differential diagnosis of thyroid nodules.
