Objective To study the multi parameters indexes of ultrasonic examination for perioperative period of thyroid nodule,and to select the characteristic variables of the differential diagnosis of benign and malignant thyroid nodules,and the diagnosis value was evaluated. Method Conventional ultrasound,ultrasonic elastography and ultrasound contrast examinations were conducted to 63 thyroid nodules,the imaging symptoms of each indicator were observed,and the diagnosis effect of the evaluation indicators on malignant thyroid nodules were analyzed with chi-square test,logistic regressive analysis and ROC curve etc.Results The single factor analysis was carried out on various indexes in different examination methods. There were statistically significant indicators including echo of the nodule,nodule boundary,micro calcification,elasticity imaging grading,the degree of contrast enhancement and enhanced morphology,edge enhancement. Logistic regression analysis showed that the micro calcification,nodular uneven or lobulated boundary,elasticity imaging grading of IV-V,low enhancement were significant predictor for malignant nodules diagnosis. The area under the ROC curve showed that the lower area of curve of single diagnosis indicator to the nodule diagnosis was more than 0.8,while the combined diagnosis showed that it was more than 0.9. ConclusionThe combined application of conventional ultrasound,contrast-enhanced ultrasound and ultrasound elasticity imaging,multi parameter markers can significantly improve the diagnostic accuracy of benign and malignant thyroid nodules.%目的 分析甲状腺结节围手术期超声检查的多参数指标,筛选出对甲状腺结节良恶性鉴别诊断显著的特征变量,评估其诊断价值.方法 选取行手术治疗的甲状腺结节患者54例(63个甲状腺结节),术前均行常规高频超声、超声弹性成像及超声造影检查,分析各种检查方法的多项指标,构建受试者工作曲线评估并确定诊断标准.结果 对不同检查方法中各项指标进行单因素分析,有统计学意义的指标有实性部分回声、结节边界、微钙化、弹性成像分级、增强程度、增强形态、增强边界.Logsitic回归分析显示微钙化、结节边界模糊呈分叶状及浸润、弹性成像分级IV-V级、超声造影低增强对恶性结节诊断预测作用显著.ROC曲线下面积显示单个诊断指标对恶性甲状腺结节诊断曲线下面积均>0.8,而多参数联合诊断曲线下面积均>0.9.结论 联合应用常规超声、超声造影及超声弹性成像检查,多参数指标联合可明显提高甲状腺结节良恶性的鉴别诊断准确率.
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