摘要
目的:观察超声造影(CEUS)联合血清促甲状腺激素(TSH)水平检测对甲状腺微小结节良、恶性的诊断价值。方法:选择2019年1月至2021年2月在本院接受手术治疗的94例甲状腺微小结节患者。所有患者均接受CEUS检查及血清TSH检测,比较良性组与恶性组血清TSH水平和超声参数[上升时间(RT)、平均渡越时间(MTT)、峰值降半时间(TPH)、上升斜率(WIS)、达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)]。对比CEUS联合血清TSH检测结果与术后病理诊断结果的符合率。采用受试者工作特征(ROC)曲线分析CEUS参数及血清TSH检测对于结节良、恶性的诊断效能。结果:94例患者(166个甲状腺微小结节)中,63例为良性(108个,良性组),31例为恶性(58个,恶性组)。良性组血清TSH水平显著低于恶性组(P<0.05)。良性组与恶性组RT、MTT、TPH、WIS、TTP比较,差异均无统计学意义(均P>0.05);良性组PI低于恶性组,AUC高于恶性组(均P<0.05)。PI、AUC联合TSH诊断符合率(98.79%)高于PI联合TSH(87.80%)、AUC联合TSH(90.25%)(P<0.05)。PI、AUC联合TSH诊断的准确率、灵敏度和特异度(82.93%、84.98%、86.11%)高于PI联合TSH(69.43%、72.48%、76.81%)或AUC联合TSH(73.18%、75.63%、78.09%),PI、AUC联合TSH诊断的ROC曲线下面积[0.829(0.432~0.917)]高于PI联合TSH[0.694(0.484~0.819)]或AUC联合TSH[0.732(0.386~0.891)]。结论:CEUS参数PI、AUC联合血清TSH检测可提高甲状腺微小结节良、恶性的鉴别诊断效能。
Objective:To observe the diagnostic value of contrast-enhanced ultrasound(CEUS)combined with serum thyroid-stimulating hormone(TSH)levels test for benign and malignant thyroid micronodules.Methods:Ninety-four patients with thyroid micronodules who underwent surgery in our hospital from January 2019 to February 2021 were selected.All patients underwent CEUS and serum TSH test,and serum TSH levels and ultrasound parameters[rise time(RT),mean transit time(MTT),time from peak to one half(TPH),wash-in slope(WIS),time to peak(TTP),peak intensity(PI),and area under the curve(AUC)]were compared between the benign and malignant groups.The CEUS combined with serum TSH test results were compared with the postoperative pathological diagnostic results.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of CEUS parameters and serum TSH test for benign and malignant nodules.Results:Of the 94 patients(166 thyroid micronodules),63 were benign(108 micronodules,benign group)and 31 were malignant(58micronodules,malignant group).Serum TSH levels were significantly lower in the benign group than in the malignant group(P<0.05).The differences were not statistically significant when comparing RT,MTT,TPH,WIS and TTP between benign and malignant groups(all P>0.05);PI was lower in benign group than that in malignant group and AUC was higher than malignant group(all P<0.05).The diagnostic compliance rate of PI and AUC combined with TSH diagnosis(98.79%)was higher than PI combined with TSH(87.80%)and AUC combined with TSH(90.25%)(P<0.05).The accuracy,sensitivity and specificity of PI and AUC combined with TSH diagnosis(82.93%,84.98%,86.11%)were higher than those of PI combined with TSH(69.43%,72.48%,76.81%)or AUC combined with TSH(73.18%,75.63%,78.09%).The area under the ROC curve for PI and AUC combined with TSH diagnosis[0.829(0.432-0.917)]was higher than those for PI combined with TSH[0.694(0.484-0.819)]or AUC combined with TSH[0.732(0.386-0.891)].Conclusion:CEUS parameters PI and AUC combined with serum TSH test can improve the efficacy of differential diagnosis for benign and malignant thyroid micronodules.
作者
王静
杨超
王刚
曹冰
Wang Jing;Yang Chao;Wang Gang;Cao Bing(Xuzhou Cancer Hospital,Xuzhou 221000,China)
出处
《广西医科大学学报》
CAS
2022年第8期1308-1312,共5页
Journal of Guangxi Medical University
关键词
超声造影
血清促甲状腺激素
甲状腺结节
鉴别诊断
contrast-enhanced ultrasound
serum thyroid-stimulating hormone
thyroid nodules
differential diagnosis
