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ID:33714521
大小:5.09 MB
页数:39页
时间:2019-02-28
《弹性成像应变率比值法和等级评分法对甲状腺结节良恶性诊断的对比研究》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、南昌大学硕士学位论文弹性成像应变率比值法和等级评分法对甲状腺结节良恶性诊断的对比研究姓名:宋焱申请学位级别:硕士专业:影像医学与核医学指导教师:章春泉201205摘要目的:探讨超声弹性应变率比值法和等级评分法对甲状腺结节良恶性的鉴别诊断价值,并对两种方法进行比较。方法:选择85个甲状腺结节病灶进行超声弹性成像检查,获得超声弹性成像(UE)图像后,用5级评分法对结节进行评分;测量结节与同侧胸锁乳突肌组织的弹性应变率(StrainRatio,SR)比值;两种方法所得结果分别与术后病理对照,采用受试者工作特
2、征(ROC)曲线来确定良恶性结节SR比值的临界值。结果:①甲状腺结节良性组弹性应变率比值为0.94+0.22,恶性组弹性应变率比值为2.67+0.73,两组问差异有统计学意义(P---0.03)。②通过ROC曲线确定良恶性结节弹性应变率比值的临界点为1.45,其准确性92.94%,敏感性88.89%,特异性94.03%。③甲状腺良恶性结节弹性应变率比值的ROC曲线下面积为0.95,等级评分法的ROC曲线下面积为O.89,二者差异无统计学意义(Z=.1.00,P>0.05)。④弹性应变率比值法与5级评分
3、法之间的准确性,敏感性,特异性比较,差异无统计学意义(P>0.05)。结论:应用胸锁乳突肌作为对照物测量甲状腺结节应变率比值是可行的。甲状腺恶性结节弹性应变率比值高于良性结节,甲状腺恶性结节的硬度大于良性结节。应变率比值法同等级评分法一样,是一种对甲状腺结节良恶性判断有效、有价值的影像学诊断方法,但作为一种半定量的评估方法较等级评分法更为客观。关键词:超声弹性成像;甲状腺结节;胸锁乳突肌;弹性应变率比值;弹性成像等级评分AbstractABSTRACTobjective:Toexploretheval
4、ueofstrainratiomethodandscoringsysteminultrasoundelastographyfordifferentiatingthebenignandmalignantthyroidnodules,andtocomparethetwomethods.Method:85thyroidnoduleswerechosentoundergoultrasoundelastography(UE),andwereevaluatedwith5一scoringsystemmethod,s
5、trainratioindexesofthethyroidnoduleswerecalculatedaswellasthesternocleidomastoidmuscletissue,withpathologicresultsasthereferencestandard.Areceiver-operatingcharacteristic(ROC)curvewasusedtoidentifythecutoffpointfordifferentialdiagnosisofthyroidnodules.R
6、esult:@Thestrainratioofthebenignlesionswas0.94+0.22,whichwassignificantlydifferentfromthevalueofmalignantlesions2.67+0.73rP=0.03).@Itshowedthatthebestcut-offpointofROCcurveforbenignandmalignantnoduleswas1.45,withhighaccuracy(92.94%),sensitivity(88.89%),
7、specificity(94.03%、.@Theareaunderthecurve(AUC)ofstrainratioevaluationwas0.95,theAUCofscoringsystemevaluationwas0.89.Thedifferencebetweenthemwasnosignificant.@Comparetheaccuracy,sensitivityandspecificityofthetwomethods,thedifferencebetweenthemwasnosignif
8、icant.Conclusion:Applicationofthestemocleidomastoidmuscleascounterparttomeasurethyroidnodulestrainratioisfeasible.Theelasticstrainratioofthyroidmalignantnodulesishigherthanbenignones,thehardnessofthyroidcarcinomaisgreaterthantheb
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