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目的:探讨弹性成像评分法及弹性应变率比值法在甲状腺结节良恶性诊断中最佳诊断界点。方法:对78例共122个甲状腺结节术前行弹性成像检查并获得应变率比值(SR),根据病理结果分为良性组90个结节和恶性组32个结节。结果:(1)弹性成像评分法:78例122个结节术前超声弹性评分为1-3分有90个结节,与病理诊断符合74个结节弹性评分为4分和5分有32个结节,与病理诊断符合24个结节,对应的诊断敏感度为75%,特异度为82%,准确率为80%;(2)弹性应变率比值:良性组结节90个,SR平均值为2.34+1.02;恶性组结节32个,SR平均值为4.15+1.09;(3)通过ROC曲线确定SR最佳诊断点为3.30,对应的应变率比值法诊断敏感度为81%,特异度为90%,准确率为87%,ROC曲线下面积(AUC)为0.831。结论:弹性应变率比值法可用于甲状腺结节良恶性的判断,为甲状腺弹性成像检查提供了一项新的诊断指标。
OBJECTIVE: To explore the best diagnostic threshold of elastography scoring method and elastic strain rate ratio in benign and malignant thyroid nodules. Methods: A total of 122 cases of thyroid nodules underwent elastography before operation and got the strain rate ratio (SR). According to the pathological results, they were divided into 90 nodules of benign group and 32 nodules of malignant group. Results: (1) Elastography scoring method: 78 cases of 122 nodules preoperative ultrasound elastic score of 1-3 nodules have 90 nodules, with the pathological diagnosis of 74 nodules elastic score of 4 points and 5 points 32 A nodule, consistent with the pathological diagnosis of 24 nodules, the corresponding diagnostic sensitivity was 75%, specificity was 82%, the accuracy rate was 80%; (2) elastic strain rate ratio: 90 benign nodules, SR The average value was 2.34 + 1.02; the malignant group had 32 nodules, the average value of SR was 4.15 + 1.09; (3) The optimal diagnosis point of SR was 3.30 by ROC curve, and the corresponding diagnostic sensitivity of strain rate ratio method was 81% The specificity was 90% and the accuracy was 87%. The area under the ROC curve (AUC) was 0.831. Conclusion: The method of elastic strain rate ratio can be used to judge benign and malignant thyroid nodules and provide a new diagnostic index for thyroid elastography.