甲状腺结节,超声应变弹性成像,超微血流成像,诊断," /> 甲状腺结节,超声应变弹性成像,超微血流成像,诊断,"/> ,Ultrasonic strain elastography,Ultra-micro blood flow imaging,Diagnosis,"/>  <span>SE</span><span style="font-family:宋体;">联合</span><span>SMI</span><span style="font-family:宋体;">检查鉴别甲状腺结节的临床分析</span>

临床肿瘤学杂志 ›› 2022, Vol. 27 ›› Issue (03): 250-254.

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 SE联合SMI检查鉴别甲状腺结节的临床分析

  

  1.  223300  江苏淮安  南京医科大学附属淮安第一医院超声科
  • 收稿日期:2021-01-29 修回日期:2021-12-29 出版日期:2022-03-25 发布日期:2022-05-12

Differential value of SE combined with SMI detection in thyroid nodules

  1. Department of Ultrasound, the First Affiliated Huaian Hospital of Nanjing Medical University, Huaian 223300, China
  • Received:2021-01-29 Revised:2021-12-29 Online:2022-03-25 Published:2022-05-12

摘要: 目的  探讨超声应变弹性成像(SE)联合超微血流成像(SMI)检查在甲状腺结节中的鉴别价值。方法  收集20195月至20208 80例甲状腺结节患者的影像学及临床资料,以病理检查结果为金标准,分为良性组(n=34)与恶性组(n=46),两组患者均行SESMI。应用超声弹性评分标准评价SE检测甲状腺结节的结果,根据Alder血流分级评价SMI检测甲状腺结节的结果,采用受试者工作特征(ROC)曲线分析SESMI单独及联合诊断甲状腺结节的诊断效能。结果  SE检测的甲状腺恶性结节超声弹性评分明显高于良性结节(P=0.000)。共检出38例恶性结节,其中良性组5例,恶性组33例。以4分为截断值,13分恶性率为31.0%13/42),45分恶性率为86.8%33/38)。SMI检测的恶性甲状腺结节Alder血流分级明显高于良性结节(P=0.000)。共检出39例恶性结节,其中良性组7例,恶性组32例。以2级为截断值,01级恶性率为34.1%14/41),23级恶性率为82.1%32/39)。甲状腺结节良恶性诊断中,SESMI及两者联合预测的的灵敏度分别为0.6900.6590.871,特异度分别为0.8680.8210.857,准确性分别为0.7750.7380.863ROC曲线下面积分别为0.7850.7450.854。结论  与单独诊断相比,SESMI联合诊断能够有效提高甲状腺结节良恶性的诊断效能,具有较高的鉴别价值。

关键词: font-size:10.5pt, 甲状腺结节')">">甲状腺结节, 超声应变弹性成像, 超微血流成像, 诊断

Abstract:  Objective  To explore the value of ultrasonic strain elastography (SE) combined with supermicro blood flow imaging (SMI) in the identification of thyroid nodules. Methods  The imaging and clinical data of 80 patients with thyroid nodules who were examined from May 2019 to August 2020 were selected, and pathological examination results were used as the gold standard, and patients were divided into benign group (n=34) and malignant group (n=46), SE and SMI were performed in both groups. The ultrasound elasticity scoring standard was used to evaluate the results of SE detection of thyroid nodules, the results of SMI detection of thyroid nodules were evaluated according to Alder blood flow classification, and receiver operating characteristic curve (ROC)was used to analyze the diagnostic efficiency of SE and SMI alone and in combination in the diagnosis of thyroid nodules. ResultsThe ultrasonic elastic score of malignant thyroid nodules detected by SE was significantly higher than that of benign nodules (P=0.000). A total of 38 cases of malignant nodules were detected, including 5 cases in benign group and 33 cases in malignant group. Taking 4 points as the cut-off value, the malignant rate of 1-3 points was 31.0% (13/42), and the malignant rate of 4-5 points was 86.8% (33/38). The Alder blood flow grade of malignant thyroid nodules detected by SMI was significantly higher than that of benign nodules (P = 0.000). A total of 39 cases of malignant nodules were detected, including 7 cases in benign group and 32 cases in malignant group. Taking grade 2 as the cut-off value, the malignant rate of grade 0-1 was 34.1% (14/41), and the malignant rate of grade 2-3 was 82.1% (32/39). In the diagnosis of benign and malignant thyroid nodules, the sensitivity of SE, SMI and their combination were 0.690, 0.659 and 0.871 respectively, the specificity were 0.868, 0.821 and 0.857 respectively, the accuracy were 0.775, 0.738 and 0.863 respectively, and the areas under the ROC curve were 0.785, 0.745 and 0.854 respectively. Conclusion  Compared with separate diagnosis, the combined diagnosis of SE and SMI can effectively improve the diagnostic efficiency of benign and malignant thyroid nodules, and has a higher reference value.

Key words: Thyroid nodules')">">, Ultrasonic strain elastography')">">, Ultra-micro blood flow imaging">-micro blood flow imaging')">">, Diagnosis

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