系统评价甲状腺结节诊断的Meta分析.docVIP

第四军医大学硕士学位论文 Meta-analysis of diagnostic methods for systemic evaluation of thyroid nodules Candidate for master: Yaoshan Supervisor:Prof. Jiao Kai Department of Endocrinology, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038, China Abstract Key words:Thyroid nodules;FNAC;Ultrasound;Radionuclide imaging;Ultrasound elasticity;Meta analysis. Thyroid nodule is a common clinical disease with very high incidence. According to the American Thyroid Association survey, 4%-10% of the general population has thyroid nodules detected by palpation. In recent years with high resolution ultrasound, the detection rate can be as high as 19%-67％. The rate in autopsy (60 years and above) is about 50%. But only about 5% of thyroid nodules are malignant [1]. Therefore, judgment of benign or malignant thyroid nodules has important clinical significance for treatment selection and prognosis. B ultrasound is a fast, economic, and noninvasive method for auxiliary examination of thyroid nodules, and can be used to determine the location and size of thyroid nodules, membrane integrity, intra-nodal flow, and occurrence of calcification. B ultrasound can also be used to check the relationships of thyroid nodules with larynx and trachea, and the size of cervical lymph node. B ultrasound also facilitates the dynamic follow-up of thyroid -5- 第四军医大学硕士学位论文 nodule. The ultrasonic elastography (UE) as a new diagnostic ultrasonography in recent years has been increasingly helpful in the studies and diagnosis of thyroid nodule (TN). The basic principle of UE is: first cause the organizations to deform under external force (manual compression or high-energy pulsed push), then detect the deformation by using special algorithm and computer technology, and display the relative deformation degree in the gray-scale and color coding. The results show the hardness of mass qualitatively or quantitatively, which is traditionally estimated by doctors through palpation. This is propitious t