本文選題：甲狀腺腫瘤　切入點：甲狀腺結(jié)節(jié)　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2015年11期 　論文類型：期刊論文

【摘要】：目的甲狀腺乳頭狀微小癌(PTMC)術(shù)前定性診斷比較困難,容易漏診和誤診,本文旨在探討CT徑線比鑒別診斷PTMC與良性結(jié)節(jié)的價值。資料與方法選取經(jīng)手術(shù)病理證實為直徑≤1.0 cm的甲狀腺良惡性微小結(jié)節(jié)的78例患者共154個結(jié)節(jié),分為PTMC組47例共75個結(jié)節(jié)和良性微小結(jié)節(jié)組31例共79個結(jié)節(jié)。測量計算橫斷面前后徑和橫徑比值(A/T)、矢狀面前后徑和上下徑比值(A/L)和冠狀面上下徑和橫徑比值(L/T),繪制A/T、A/L和L/T診斷PTMC的ROC曲線,比較其曲線下面積,計算CT徑線比診斷PTMC的靈敏度、特異度、準(zhǔn)確度、陽性預(yù)測值及陰性預(yù)測值。比較兩組CT征象及其診斷PTMC的準(zhǔn)確率。結(jié)果 PTMC組的A/T、A/L顯著大于良性結(jié)節(jié)組(P0.01),L/T小于良性結(jié)節(jié)組(P0.01)。A/T、A/L和L/T ROC曲線下面積分別為0.8841、0.7676和0.4052,A/T和A/L的最佳診斷界值為1.05和1.0,A/T≥1.05診斷PTMC的敏感度、特異度、準(zhǔn)確度、陽性預(yù)測值和陰性預(yù)測值分別為88.00%%、84.81%、86.36%、84.62%和88.12%,A/L≥1.0診斷PTMC的敏感度、特異度、準(zhǔn)確度、陽性預(yù)測值和陰性預(yù)測值分別為66.67%、82.28%、74.68%、78.13%和72.22%。PTMC組CT征象:結(jié)節(jié)位于腺體表淺部位、類圓形低密度、邊界模糊不清、結(jié)節(jié)內(nèi)細(xì)顆粒鈣化和漸進(jìn)性填充式強化診斷PTMC的準(zhǔn)確度分別為71.43%、50.00%、79.22%、68.83%和90.91%。結(jié)論 CT徑線比對診斷PTMC有較高的價值,A/T≥1.05、A/L≥1.0可以作為CT診斷PTMC的重要指標(biāo)。
[Abstract]:Objective it is difficult to diagnose papillary thyroid carcinoma with PTMC before operation, and it is easy to miss diagnosis and misdiagnosis. The purpose of this study was to investigate the value of CT line ratio in the differential diagnosis of PTMC and benign nodules. Materials and methods A total of 154 nodules were selected from 78 patients with benign and malignant thyroid nodules whose diameters were less than 1.0 cm proved by surgery and pathology. There were 47 cases with 75 nodules in PTMC group and 31 cases with benign micronodule group. The ratio of anteroposterior diameter and transverse diameter of cross section was measured and calculated. The ratio of anterior and lower sagittal diameter to inferior diameter of sagittal plane and the ratio of upper and lower diameter to transverse diameter of coronal plane were measured and calculated, and the ratio of upper and lower diameter to transverse diameter of coronal plane was plotted. To make a ROC curve for the diagnosis of PTMC by A / T / A / L / L / T, The area under the curve was compared, and the sensitivity, specificity and accuracy of computed tomography (CT) ratio in diagnosing PTMC were calculated. The positive predictive value and the negative predictive value were compared between the two groups. The CT signs and the diagnostic accuracy of PTMC were compared between the two groups. Results the area under the ROC curve in PTMC group was 0.8841 0.7676 and 0.4052 A / L, respectively, which was significantly higher than that in benign nodule group (P 0.01 / L / L) than that in benign nodule group (P < 0.01). The area under the curve was 0.88410.7676 and 0.4052A / T and A / L, respectively. The best diagnostic cutoff values were 1. 05 and 1. 0 A / T 鈮，

本文編號：1601954