对比研究超声弹性应变率与常规超声鉴别甲状腺结节的价值

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摘要　目的：比较超声弹性应变率与常规超声对甲状腺结节的鉴别诊断价值。方法：对165例患者的196个甲状腺结节进行常规超声及弹性成像检查，常规超声采用半定量评分方法判断结节的性质，计算弹性应变率并构建ROC曲线，获得最佳诊断界值，以术后病理结果为金标准，比较弹性应变率、常规超声及联合诊断的诊断价值。结果：弹性应变率诊断甲状腺良恶性结节的ROC曲线下面积（Az）为0.826，最佳诊断界值为2.51，弹性应变率诊断敏感性、特异性、准确性分别为81.63％、72.79％、75.00％；常规超声诊断敏感性、特异性、准确性分别为77.55%、74.83%、75.51%；联合诊断的敏感性、特异性、准确性分别为73.47%、88.43%、84.69%。弹性应变率与常规超声准确性比较无统计学意义（χ2=1.45，P>0.05）。联合诊断的准确性明显高于弹性应变率（χ2=20.48，P<0.05）与常规超声（χ2=14.70，P<0.05）。结论：弹性应变率在鉴别诊断甲状腺良恶性结节方面有中等价值，与常规超声联合诊断对准确性有明显提高。

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	安秀艳
	丛淑珍
	钱隽
	赵晓虹
	甘科红
	梁婷

关键词 ：甲状腺结节, 超声检查, 多普勒, 彩色

Abstract：Objective: To compare the value of strain ratio in ultrasonic elestography and gray-scale ultrasonography in differentiating benign and malignant thyroid nodules. Methods: A total of 165 patients with 196 thyroid nodules underwent conventional ultrasonography and elastography. The strain ratio of nodules were calculated. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of strain ratio. The sensitivity, specificity and accuracy were compared with gray-scale ultrasonography. Results: The area under the ROC curve(Az) of the strain ratio was 0.826. The strain ratio of 2.51 was the best diagnostic cut-off point. The sensitivity, specificity and accuracy of strain ratio were 81.63％, 72.79％ and 75.00％. The sensitivity, specificity and accuracy of gray-scale ultrasonography were 77.55%, 74.83% and 75.51%. The sensitivity, specificity and accuracy of combined diagnosis were 73.47%, 88.43% and 84.69%, respectively. The difference between strain ratio and gray-scale ultrasonography was not significant(χ2=1.45, P>0.05). The accuracy of combined diagnosis was higher than that of strain ratio(χ2=20.48， P<0.05) or gray-scale ultrasonography(χ2=14.70, P<0.05) alone. Conclusion: Strain ratio has moderate degree of diagnostic value in differentiating the benign and malignant thyroid nodules. Combination of strain ratio and gray scale ultrasonography can increase diagnostic accuracy significantly.

Key words： Thyroid nodule Ultrasonography Doppler color

收稿日期: 2012-08-10

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引用本文:

安秀艳;丛淑珍;钱隽;赵晓虹;甘科红;梁婷. 对比研究超声弹性应变率与常规超声鉴别甲状腺结节的价值[J]. , 2013, 24(2): 85-87.
AN Xiu-yan;CONG Shu-zhen;QIAN Jun;ZHAO Xiao-hong;GAN Ke-hong;LIANG Ting. Comparative study of strain ratio in ultrasonic elestography and gray-scale ultrasonography for differential diagnosis of thyroid nodules. , 2013, 24(2): 85-87.

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