目的探讨常规超声、超声造影及两者联合鉴别诊断甲状腺结节的价值。方法回顾性分析95例单发甲状腺结节患者的常规超声、超声造影资料，采用多元Logistic回归获得常规超声、超声造影及两者联合诊断甲状腺恶性结节的模型方程，计算3个模型诊断甲状腺恶性结节的准确率、敏感度和特异度，绘制ROC曲线评价3种方法诊断甲状腺恶性结节的能力。结果常规超声诊断甲状腺恶性结节的主要指标为形态不规则，砂粒样钙化及无声晕；超声造影诊断甲状腺恶性结节的主要指标为灌注时间快，弥漫性整体增强为主；常规超声联合超声造影诊断甲状腺恶性结节的主要指标为形态不规则，砂粒样钙化、无声晕及弥漫性整体增强；2种方法联合诊断甲状腺恶性结节的准确率、特异度、敏感度分别为91．4%、88．2%、96．6%，均高于单一的诊断方法。结论常规超声和超声造影二者联合应用可提高鉴别甲状腺结节良恶性的水平。%Objective To explore the value of conventional ultrasound , contrast-enhanced ultrasound and ul-trasound combined with contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nod-ules. Methods Ultrasonography ,contrast data of 95 patients with thyroid nodules were retrospectively analyzed. Multinomial Logistic regression was used to create the Logistic equations and to obtain the accuracy, specificity and sensitivity of conventional ultrasound ,contrast-enhanced ultrasound and conventional ultrasound combined with con-trast-enhanced ultrasound for diagnosing thyroid cancer. ROC curves for diagnosing thyroid cancer were drawn and the diagnostic abilities of the three methods were compared. Results Foliar margins, sand samples calcification and no halo for conventional ultrasound, quickly perfusion and homogeneous enhancement for contrast-enhanced ultra-sound, and Foliar margins, sand samples calcification , no halo and homogeneous enhancement for conventional ultra-sound combined with contrast-enhanced ultrasound were the main evidences for diagnosing thyroid cancer. The accu-racy , specificity and sensitivity of combination of the two methods was 91.4%, 88.2%, 96.6%. Which was higher than single method. Conclusion The abilities of conventional ultrasound and contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules were similar, combination of the two methods can improve the diag-nosticability.
展开▼
