中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
Chinese Journal of Medical Imaging
2015年
9期
663-666
,共4页
金志斌%张捷%闻宝杰%张玮婧%吴敏
金誌斌%張捷%聞寶傑%張瑋婧%吳敏
금지빈%장첩%문보걸%장위청%오민
甲状腺结节%甲状腺肿瘤%超声检查,多普勒,彩色%弹性成像技术%病理学,临床%诊断,鉴别
甲狀腺結節%甲狀腺腫瘤%超聲檢查,多普勒,綵色%彈性成像技術%病理學,臨床%診斷,鑒彆
갑상선결절%갑상선종류%초성검사,다보륵,채색%탄성성상기술%병이학,림상%진단,감별
Thyroid nodule%Thyroid neoplasms%Ultrasonography,Doppler,color%Elasticity imaging techniques%Pathology,clinical%Diagnosis,differential
目的:弹性成像技术存在敏感度差等不利因素,因此限制了该技术在甲状腺结节诊断中的应用,本研究以弹性应变率比值(SR)法为基础,针对不同大小的甲状腺结节采用不同的SR计算方法,以探讨不同SR计算方法在甲状腺结节良恶性鉴别中的应用价值。资料与方法回顾性分析行甲状腺弹性超声检查、超声引导下甲状腺细针穿刺的336例患者共340个结节,以细胞病理结合随访为标准,分析固定面积法和实际面积法在不同大小甲状腺结节良恶性鉴别中的差异。结果超声诊断340个结节中,小结节91例,大结节249例。病理诊断91例小结节中恶性36例,良性55例;249例大结节中恶性104例,良性145例。对于纵、横径均≤8 mm的小结节,实际面积法判断恶性肿瘤与病理的一致性更优(χ2=20.89,P<0.01);对于纵径/横径>8 mm的大结节,固定面积法更优(χ2=57.08, P<0.01)。实际面积法诊断恶性结节的敏感度为57.10%,特异度为83.00%,符合率为72.30%(Kappa=0.413);固定面积法的诊断敏感度为73.60%,特异度为85.00%,符合率为80.30%(Kappa=0.590);根据结节大小选择性使用两种方法诊断的敏感度为85.00%,特异度为85.50%,符合率为85.30%(Kappa=0.699)。根据结节大小选择性使用两种方法诊断的敏感度最高,与病理诊断的一致性检验较单一方法更高(Kappa=0.699,P<0.01)。结论根据甲状腺结节大小选择性使用固定面积法和实际面积法可以明显提高弹性成像诊断恶性甲状腺结节的敏感性。
目的:彈性成像技術存在敏感度差等不利因素,因此限製瞭該技術在甲狀腺結節診斷中的應用,本研究以彈性應變率比值(SR)法為基礎,針對不同大小的甲狀腺結節採用不同的SR計算方法,以探討不同SR計算方法在甲狀腺結節良噁性鑒彆中的應用價值。資料與方法迴顧性分析行甲狀腺彈性超聲檢查、超聲引導下甲狀腺細針穿刺的336例患者共340箇結節,以細胞病理結閤隨訪為標準,分析固定麵積法和實際麵積法在不同大小甲狀腺結節良噁性鑒彆中的差異。結果超聲診斷340箇結節中,小結節91例,大結節249例。病理診斷91例小結節中噁性36例,良性55例;249例大結節中噁性104例,良性145例。對于縱、橫徑均≤8 mm的小結節,實際麵積法判斷噁性腫瘤與病理的一緻性更優(χ2=20.89,P<0.01);對于縱徑/橫徑>8 mm的大結節,固定麵積法更優(χ2=57.08, P<0.01)。實際麵積法診斷噁性結節的敏感度為57.10%,特異度為83.00%,符閤率為72.30%(Kappa=0.413);固定麵積法的診斷敏感度為73.60%,特異度為85.00%,符閤率為80.30%(Kappa=0.590);根據結節大小選擇性使用兩種方法診斷的敏感度為85.00%,特異度為85.50%,符閤率為85.30%(Kappa=0.699)。根據結節大小選擇性使用兩種方法診斷的敏感度最高,與病理診斷的一緻性檢驗較單一方法更高(Kappa=0.699,P<0.01)。結論根據甲狀腺結節大小選擇性使用固定麵積法和實際麵積法可以明顯提高彈性成像診斷噁性甲狀腺結節的敏感性。
목적:탄성성상기술존재민감도차등불리인소,인차한제료해기술재갑상선결절진단중적응용,본연구이탄성응변솔비치(SR)법위기출,침대불동대소적갑상선결절채용불동적SR계산방법,이탐토불동SR계산방법재갑상선결절량악성감별중적응용개치。자료여방법회고성분석행갑상선탄성초성검사、초성인도하갑상선세침천자적336례환자공340개결절,이세포병리결합수방위표준,분석고정면적법화실제면적법재불동대소갑상선결절량악성감별중적차이。결과초성진단340개결절중,소결절91례,대결절249례。병리진단91례소결절중악성36례,량성55례;249례대결절중악성104례,량성145례。대우종、횡경균≤8 mm적소결절,실제면적법판단악성종류여병리적일치성경우(χ2=20.89,P<0.01);대우종경/횡경>8 mm적대결절,고정면적법경우(χ2=57.08, P<0.01)。실제면적법진단악성결절적민감도위57.10%,특이도위83.00%,부합솔위72.30%(Kappa=0.413);고정면적법적진단민감도위73.60%,특이도위85.00%,부합솔위80.30%(Kappa=0.590);근거결절대소선택성사용량충방법진단적민감도위85.00%,특이도위85.50%,부합솔위85.30%(Kappa=0.699)。근거결절대소선택성사용량충방법진단적민감도최고,여병리진단적일치성검험교단일방법경고(Kappa=0.699,P<0.01)。결론근거갑상선결절대소선택성사용고정면적법화실제면적법가이명현제고탄성성상진단악성갑상선결절적민감성。
PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.