论文部分内容阅读
目的探讨强回声晕在甲状腺良恶性结节中的诊断价值及其病理成分。方法回顾性分析2015年1月~2016年5月在舟山医院就诊的306例患者410个结节,所有结节均经手术切除并且病理证实。患者术前均进行常规超声检查,并由经验丰富的超声医生记录结节直径、位置、数目、纵横比、边缘、边界、回声水平、钙化、血流分级、声晕、强回声晕、与包膜关系、淋巴结转移情况。先进行单因素分析筛选出有统计学意义的指标,然后再进行多因素Logistic回归分析。以病理上结节周围出现纤维浸润带为金标准,构建ROC曲线,探讨强回声晕的病理成份。结果二元Logistic回归分析筛选出强回声晕(Ps)进入回归模型。强回声晕(常规超声)的ROC曲线下面积为0.748,强回声晕(Ps)的ROC曲线下面积为0.761,强回声晕(常规超声)的阳性预测值为87%,阴性预测值为92.7%,强回声晕(Ps)的阳性预测值为83.3%,阴性预测值为89%。结论强回声晕对甲状腺结节良恶性的诊断具有一定的价值。强回声晕的病理成分多为癌细胞浸润伴纤维组织及炎性细胞。
Objective To investigate the diagnostic value and pathological features of hyperechoic halo in benign and malignant thyroid nodules. Methods A retrospective analysis of 410 nodules of 306 patients treated in Zhoushan Hospital from January 2015 to May 2016 was performed. All nodules were surgically removed and confirmed by pathology. Patients underwent routine ultrasound examination before surgery, and experienced surgeons recorded nodules diameter, location, number, aspect ratio, edge, boundary, echo level, calcification, blood flow classification, sound halo, Membrane relationship, lymph node metastasis. First univariate analysis of screening out statistically significant indicators, and then carry out multivariate Logistic regression analysis. Pathological nodules around the fibrous infiltration zone as the gold standard, the ROC curve constructed to explore the echogenic halo pathological components. Results Binary logistic regression analysis screened the strong echo halo (Ps) into the regression model. The area under the ROC curve of the strong echogenic halo (conventional ultrasound) was 0.748, the area under the ROC curve of the strong echo halo (Ps) was 0.761, the positive predictive value of strong echogenic halo (conventional ultrasound) was 87% and the negative predictive value was 92.7% , The positive predictive value of hyperechoic (Ps) was 83.3%, and the negative predictive value was 89%. Conclusions The echogenic halo has some value in the diagnosis of benign and malignant thyroid nodules. Hyperechoic halo pathological components mostly cancer cell infiltration with fibrous tissue and inflammatory cells.