彈性成像聯(lián)合常規(guī)超聲對甲狀腺結(jié)節(jié)性疾病診斷價值的研究
[Abstract]:Objective: to explore the diagnostic value of conventional ultrasound and elastography in the diagnosis of benign and malignant thyroid nodules, and to provide a new method for the differential diagnosis of benign and malignant thyroid nodules. To provide relevant help for the selection of clinical surgical methods and the guidance of treatment. Methods: a total of 128 thyroid nodules were examined by gray scale ultrasound, color Doppler ultrasound and elastography in 80 patients. The thyroid nodules of all patients were confirmed by pathology after operation. The location, number, size, shape, boundary, capsule, internal echo, microcalcification, internal and peripheral blood flow distribution, peak systolic blood flow velocity (PSV),) resistance index (RI) and elastic imaging score of thyroid nodules were observed. Results: 1, there were significant differences in the size, shape, boundary, capsule, internal echo and microcalcification in the gray scale ultrasound images of benign and malignant thyroid nodules (P0.05). There were significant differences in Alder blood flow classification and peak systolic blood flow velocity (PSV), resistance index (RI) between benign and malignant thyroid nodules (P0.05). There was significant difference in elastic grade between benign and malignant thyroid nodules (P0.05). 2. Conventional ultrasound was used to diagnose benign and malignant thyroid nodules, 81 benign thyroid nodules and 47 thyroid malignant nodules. The sensitivity, specificity and accuracy of conventional ultrasound were 71.8% (28 / 39), 78.7% (70 / 89) and 76.6% (98 / 128), respectively. The sensitivity, specificity and accuracy of elastography were 69.2% (27 / 39), 79.8% (71 / 89) and 76.6% (98 / 128), respectively. The sensitivity, specificity and accuracy of conventional ultrasound combined with elastography were 89. 7% (35 / 39), 95. 5% (85 / 89) and 93. 8% (120 / 128), respectively. There was no significant difference in sensitivity, specificity and accuracy between conventional ultrasound and ultrasound elastography (蠂 2 / 0.06 P 0.05), specificity (蠂 2 0 03 P 0.05) and accuracy (蠂 2 0.000 05). The sensitivity, specificity and accuracy of conventional ultrasound were significantly lower than those of combined ultrasound. The sensitivity, specificity and accuracy of elastography were significantly lower than that of combined ultrasound (蠂 2 + 5.03 P 0.05), specificity (蠂 2 + 10.2% P 0.05) and accuracy (蠂 2% 15.0% P 0.05). Conclusion: 1. Conventional ultrasound is the basis for the diagnosis of benign and malignant thyroid. In thyroid nodule, the intensity of blood flow signal is stronger than that in benign thyroid nodule. Some blood flow parameters of benign and malignant thyroid nodules are partially overlapped, so the results of conventional ultrasonography cannot be used as the diagnostic criteria for benign and malignant thyroid nodules. Other relevant means of inspection and a comprehensive analysis of multiple parameters should be used, In order to improve the accuracy of benign and malignant diagnosis of thyroid nodules. 2. The main role of elastography in the diagnosis of benign and malignant thyroid nodules is to provide the hardness information of thyroid lesions. It provides more references for the diagnosis of benign and malignant thyroid nodules. 3. By using the combination of ultrasound elastic imaging and conventional ultrasound, the accuracy of benign and malignant diagnosis of thyroid nodules can be greatly improved, which has very important clinical value.
【學位授予單位】:浙江大學
【學位級別】:碩士
【學位授予年份】:2014
【分類號】:R445.1;R581.3
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