论文部分内容阅读
目的分析甲状腺癌漏诊的原因,并分析不同量化指标诊断甲状腺癌的价值,评价超声诊断效果。方法选取2014年2月-2015年12月医院检查并住院采用活检以及手术病理证实甲状腺疾病患者174例(结节198个),其中甲状腺癌42例(42个结节),良性132例(156个结节),对比不同超声诊断技术的诊断价值。结果二维超声+CDFI敏感度、特异度、阴性预测值、符合率均高于二维超声、CDFI、弹性超声,差异有统计系意义(P<0.05);甲状腺癌收缩期血流峰值(PSV)、恶性特征评分、应变率比值高于良性病变,差异有统计学意义(P<0.05);二维超声+CDFI联合PSV、应变率比值的诊断敏感度为95.24%(40/42),特异度为92.95%(145/156),阳性预测值为78.43%(40/51),阴性预测值98.64%为(145/147),符合率为93.43%(185/198);2例甲状腺癌被误诊,均为良恶性并存,表现结节性甲状腺肿伴有微小的乳头状癌。结论合理的利用常规超声、PSV等计量指标,联合常规超声诊断甲状腺癌效果较好;良恶性并存微小恶性病灶等不典型表现是造成甲状腺癌早期误诊的主要原因。
Objective To analyze the causes of missed diagnosis of thyroid cancer and to analyze the value of different quantitative indicators in the diagnosis of thyroid cancer and to evaluate the effect of ultrasonic diagnosis. Methods A total of 174 patients with nodular thyroid disease (198 nodules) were confirmed by biopsy and pathology in our hospital from February 2014 to December 2015. There were 42 thyroid carcinomas (42 nodules), 132 benign ones (156 A nodule), compared with the diagnostic value of different diagnostic techniques. Results The sensitivity, specificity, negative predictive value and coincidence rate of two-dimensional ultrasonography + CDFI were higher than those of two-dimensional ultrasound, CDFI and elastic ultrasound (P <0.05). The peak of systolic blood flow ), Malignant feature score and strain rate were higher than benign lesions (P <0.05). The diagnostic sensitivity of two-dimensional ultrasound + CDFI combined with PSV strain rate was 95.24% (40/42) The positive predictive value was 78.43% (40/51), the negative predictive value was 98.64% (145/147), the coincidence rate was 93.43% (185/198); two cases of thyroid cancer were Misdiagnosis, are both benign and malignant, the performance of nodular goiter accompanied by tiny papillary carcinoma. Conclusion The reasonable use of routine ultrasound, PSV and other indicators, combined with conventional ultrasound in the diagnosis of thyroid cancer is better; benign and malignant coexistence of small malignant lesions and other atypical manifestations are the leading cause of early misdiagnosis of thyroid cancer.