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目的探讨超声联合硬度评分系统对甲状腺结节硬度重新评估的价值。方法对70例行甲状腺切除手术患者的170个甲状腺结节,术前分别行实时弹性成像和声脉冲辐射力成像测定其硬度。在此基础上,以联合硬度评分系统对结节的硬度进行重新评定。以硬度为依据鉴别诊断甲状腺结节的良恶性,并以病理为标准,绘制ROC曲线。用三种方法对RTE和ARFI诊断存在差异的47个甲状腺结节硬度的诊断的准确度进行比较。结果联合硬度评分系统与实时弹性成像及声脉冲辐射力相比,ROC曲线下面积分别为0.89、0.83和0.87(P>0.05)。USS硬度诊断存在差异的结节的诊断准确度高于两者(P<0.05)。结论联合硬度评分系统建立有助于提高甲状腺结节,特别是实时弹性成像和声脉冲辐射力成像对硬度存在诊断差异的甲状腺结节的硬度诊断准确度。
Objective To investigate the value of ultrasonic combined with hardness scoring system in reevaluation of thyroid nodules hardness. Methods Totally 170 thyroid nodules in 70 patients undergoing thyroidectomy were measured with real-time elastography and acoustic pulse radiography before operation. On this basis, the hardness of nodules was reassessed with the joint hardness scoring system. The diagnosis of benign and malignant thyroid nodules was based on the hardness, and the ROC curve was drawn based on the pathology. The accuracy of the diagnosis of 47 thyroid nodules was compared using three different methods for the diagnosis of RTE and ARFI. Results Compared with real-time elastography and acoustic pulsed radiation force, the area under the ROC curve was 0.89, 0.83 and 0.87, respectively (P> 0.05). The diagnostic accuracy of nodules with differences in the diagnosis of USS hardness was higher than those of the two (P <0.05). Conclusions The establishment of the joint stiffness scoring system can help to improve the diagnostic accuracy of thyroid nodules in diagnosis of thyroid nodules, especially real-time elastic imaging and acoustic pulse radiation imaging.