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目的研究超声弹性应变率与常规超声对甲状腺结节的鉴别诊断价值。方法纳入研究共126例择期手术甲状腺结节患者,共有146个结节。行术前常规超声及超声弹性成像扫描。根据常规超声结果及Stacul半定量评分法判断结节良恶性。根据超声弹性成像结果构建ROC曲线,确定诊断最佳临界点。以术后病理结果作为标准,比较超声弹性应变率、常规超声及联合诊断在甲状腺结节鉴别诊断价值。结果超声弹性应变率ROC曲线下面积(AUC)为0.827,最佳诊断界值为2.53;弹性应变率诊断灵敏度、特异度及诊断准确率分别为78.38%、72.48%及73.97%;常规超声诊断灵敏度、特异度及诊断准确率分别为75.68%、74.31%及74.68%;联合诊断灵敏度、特异度及诊断准确率分别为86.49%、88.07%及87.67%;超声弹性应变率与常规超声在灵敏度及特异度上差异无统计学意义;联合诊断特异度及诊断准确率明显高于超声弹性应变率及常规超声(P<0.05)。结论超声弹性应变率在鉴别诊断甲状腺结节具有中等价值。超声弹性应变率与常规超声联合诊断可提高甲状腺结节特异度及诊断准确率。
Objective To study the differential diagnostic value of ultrasonic elastic strain rate and thyroid nodules by conventional ultrasound. METHODS: A total of 126 patients with thyroid nodules undergoing elective surgery were included in the study, with a total of 146 nodules. Preoperative routine ultrasound and ultrasound elastography scan. According to the conventional ultrasound results and Stacul semi-quantitative score method to determine the benign and malignant nodules. According to the results of ultrasound elastography to construct ROC curve, to determine the best diagnostic critical point. To postoperative pathological results as a standard, comparative ultrasound elastic strain rate, conventional ultrasound and combined diagnosis in the differential diagnosis of thyroid nodules. Results The area under the curve of ultrasound elastic strain rate (ROC) was 0.827, and the best cutoff value was 2.53. The diagnostic sensitivity, specificity and diagnostic accuracy of elastic strain rate were 78.38%, 72.48% and 73.97% respectively. The sensitivity of conventional ultrasonic diagnosis , Specificity and diagnostic accuracy were 75.68%, 74.31% and 74.68% respectively. The sensitivity, specificity and diagnostic accuracy of the combined diagnosis were 86.49%, 88.07% and 87.67% respectively. The sensitivity and specificity of ultrasonic elastic strain rate There was no significant difference in degree between the two groups. The specificity of combined diagnosis and diagnostic accuracy were significantly higher than those of ultrasonic elastic strain rate and conventional ultrasound (P <0.05). Conclusion Ultrasound elastic strain rate in the differential diagnosis of thyroid nodules have a moderate value. Ultrasound elastic strain rate combined with conventional ultrasound diagnosis of thyroid nodules can increase the specificity and diagnostic accuracy.