摘要
目的分析彩色多普勒超声对甲状腺结节良恶性的诊断价值。方法选取2019年9月至2021年9月鹿邑县人民医院收治的疑似甲状腺病变患者62例(共80个结节)为研究对象,均开展彩超检查,将病理结果作为金标准,统计彩超对甲状腺结节性质的诊断准确度、敏感度、特异度、阳性预测值以阴性预测值情况;结合病理结果将所有患者分成良性组和恶性组,分析两组彩超检查中结节的血流信号分布形态、收缩期血流峰值(PSV)、阻力指数(RI)等血流指标水平。采取SPSS23.0统计软件建立起彩超诊断良恶性结节的Logistic回归模型,进行ROC曲线绘制同时计算出曲线下面积,检验模型的准确度、敏感度和特异度。结果病理检查发现恶性结节32个,良性结节48个。彩超检查发现恶性结节29个,良性结节51个。将病理结果作为依据,彩超检查的诊断准确度、敏感度和特异度分别为88.75%、81.25%、93.75%,阳性预测值以阴性预测值分别为89.66%、88.24%。良性组结节血流信号多处在周边部位,恶性组结节内部和周边血流信号丰富。恶性组的PSV水平高于良性组,RI水平低于良性组(P<0.05)。建立彩超诊断良恶性结节的Logistic回归模型,准确度为88.90%,敏感度为83.42%,特异度为91.86%。计算得到曲线下面积是0.957,标准误是0.022,95%CI(0.915,0.998),提示Logistic回归模型诊断准确度较好。结论彩超在甲状腺结节良恶性诊断中的准确度、敏感度和特异度较高,结合彩超图像中结节的血流信号等指标能协助临床早期诊断,为制定后续治疗方案提供参考依据。
Objective To analyze the diagnostic value of color doppler flow imaging(CDFI)in benign and malignant thyroid nodule.Methods From September 2019 to September 2021,62 patients(80 nodules in total)with suspected thyroid disease were selected from Luyi County People’s Hospital,all of them carried out color doppler ultrasound examination and took the pathological results as the gold standard,he diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of color doppler ultrasound on the nature of thyroid nodule were analyzed.All patients were divided into benign group and malignant group according to pathological results,the blood flow signal distribution,peak systolic blood flow(PSV)and resistance index(RI)of the nodules were analyzed.SPSS23.0 was used to establish Logistic regression model for diagnosing benign and malignant nodules by color doppler ultrasound,ROC curve was drawn and area under the curve was calculated to test the accuracy,sensitivity and specificity of the model.Results Pathological examination showed 32 malignant nodules and 48 benign nodules.Color doppler ultrasound showed 29 malignant nodules and 51 benign nodules.On the basis of pathological results,the diagnostic accuracy,sensitivity and specificity of color doppler ultrasound were 88.75%,81.25% and 93.75%,respectively.The positive predictive value was 89.66% and the negative predictive value was 88.24%.In the benign group,the blood flow signals were mostly located in the periphery,and in the malignant group,the blood flow signals were abundant.The level of PSV and RI in malignant group were higher than those in benign group(P<0.05).A Logistic regression model was established for the diagnosis of benign and malignant nodules by color doppler ultrasound,the accuracy was 88.90%,the sensitivity was 83.42%,and the specificity was 91.86%.The area under the curve is 0.957,the standard error is 0.022,and the 95%,confidence interval is(0.915,0.998),which indicates that the Logistic regression model has better diagnostic accuracy.Conclusion Color doppler ultrasound has a high accuracy,sensitivity and specificity in the diagnosis of benign and malignant thyroid nodule,and it can assist in the early clinical diagnosis by combining the blood flow signals of nodules in color doppler ultrasound images,to provide reference basis for making follow-up treatment plan.
作者
闫凤华
YAN Fenghua(Department of ultrasound,Luyi County People’s Hospital,Zhoukou Henan 477200,China)
出处
《临床研究》
2022年第1期117-120,共4页
Clinical Research
关键词
甲状腺结节
良恶性
彩色多普勒超声
准确度
thyroid nodule
benign and malignant
color doppler ultrasound
accuracy
