超声征象Logistic回归分析诊断甲状腺恶性结节

摘要

目的 探讨Logistic回归分析在常规超声及CEUS诊断甲状腺良恶性结节中的价值.方法 选取经超声引导下穿刺活检或术后病理证实的甲状腺结节患者218例,其中恶性结节74例,良性结节144例,观察结节边界、形态、纵横比、微钙化、回声类型、血流分级以及CEUS增强模式等超声特征,并对其行单因素分析,以有统计学意义的指标为因变量,行多因素Logistic回归分析,建立ROC曲线.结果 单因素分析显示低回声、形态不规则、边界不清、纵横比≥1、微钙化、血流分级(Ⅰ、Ⅱ级)、不均匀增强及低增强是诊断甲状腺恶性结节的重要指标(P均＜0.01).多因素分析显示形态不规则、微钙化、不均匀增强及低增强是甲状腺恶性结节的独立预测指标(P均＜0.05).以Logistic回归模型预测甲状腺恶性结节的准确率为82.57％,ROC曲线下面积为0.906.结论 根据甲状腺结节边界、形态、纵横比、微钙化、回声类型、血流分级以及CEUS增强特征建立的Logistic回归模型有助于诊断甲状腺恶性结节.%Objective To investigate the value of conventional ultrasound and CEUS in diagnosis of thyroid nodules with Logistic regression models.Methods A total of 218 cases of thyroid nodules (74 cases of malignant,144 cases of benign nodules) confirmed by pathology were enrolled.The boundary,morphology,anteroposterior and transverse diameter ratio,microcalcification,internal echogenicity,blood distribution and enhanced pattern of nodules were observed and analyzed with univariate analysis.The Logistic regression model was established with parameters which were significantly different of those features,and the receiver operating characteristic curves (ROC) were constructed.Results Hypoechoic,irregular morphology,blurred boundary,anteroposterior and transverse diameter ratio≥ 1,microcalcifications,blood distribution (Ⅰ,Ⅱ),heterogeneous enhanced pattern and low enhanced were significantly prognostic factors (all P＜0.01).Irregular morphology,microcalcifications,heterogeneous enhanced and low enhanced were independent prognostic factors (all P＜0.05).The accuracy of Logistic regression model was 82.57％,and the area under ROC curve was 0.906.Conclusion The Logistic regression model of boundary,morphology,anteroposterior and transverse diameter ratio,microcalcifica tions,internal echogenicity,blood distribution and enhanced pattern can help to diagnose malignant thyroid nodules.