超声联合硬度评分系统在甲状腺微小结节诊断中的应用价值.pdfVIP

768 2015 10 12 10 Chin J Med Ultrasound(Electronic Edition), October 2015, Vol.12, No.10 · · 中华医学超声杂志(电子版) 年 月 第 卷 第 期 • 浅表器官超声影像学 • 超声联合硬度评分系统在甲状腺微小结节 诊断中的应用价值 朱隽　詹嘉　刁雪红　万敏　王慧芳　陈悦 【摘要】　目的　探讨超声联合硬度评定系统在甲状腺微小结节诊断中的应用价值。方法　对 30 例 行甲状腺切除手术患者的 67 个甲状腺微小结节，术前分别行实时弹性成像和声脉冲辐射力成像评定 成像测定其硬度。在此基础上，以联合硬度评定系统对甲状腺结节硬度进行评定，以硬度为依据鉴别 诊断甲状腺结节的良恶性，并以病理为标准，绘制 ROC 曲线。结果　实时弹性成像鉴别诊断甲状腺 良恶性的敏感度、特异度、阳性预测值、阴性预测值、准确性分别为58.8%、96.9%、95.2%、69.6%、 77.6% 。声脉冲辐射力成像鉴别诊断甲状腺良恶性的敏感度、特异度、阳性预测值、阴性预测值、准 确性分别为 76.4%、75.8%、76.4%、75.8%、76.1% 。联合硬度评定系统鉴别诊断甲状腺良恶性的敏感 度、特异度、阳性预测值、阴性预测值、准确性分别为 91.2%、93.9%、93.9%、91.2%、92.5% 。联合 Z=8.72 系统与实时弹性成像以及声脉冲辐射力成像相比，ROC 曲线下面积分别为0.98，0.93 和 0.88 （ ， P ＜0.05 ）。结论　联合硬度评分系统有助于提高术前甲状腺微小结节良恶性鉴别诊断的准确性。 【关键词】联合硬度评分系统；实时弹性成像；声脉冲辐射力；甲状腺微小结节 The value of combined stiffness score system for the diagnosis of thyroid micronodules　Zhu Jun, Zhan Jia, Diao Xuehong, Wan Min, Wang Huifang, Chen Yue. Department of Ultrasound, Huadong Hospital of Fudan University, Shanghai 200040, China Corresponding author: Zhan Jia, Email: zhanjia@fudan.sh Abstract Objective To assess the value of combined stiffness score system (CSSS) in differential 【 】　 　 diagnosis of thyroid micronodules. Methods　30 patients with 67 thyroid nodules underwent real-time elastography (RTE) and acoustic radiation force impulse (ARFI) imaging before thyroidectomy , then CSSS were taken to re-evaluate the stiffness of the thyroid nodules. Compared with pathological findings, ROC curves were drawn to evaluate the diagnostic accuracy. Result　The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of RTE for differential diagnosis were 58.8%, 96.9%, 95.2%, 69.6%, 77.6%, while