摘要
目的研究超微血流显像(SMI)在甲状腺微小结节(TSN)诊断中的应用价值。方法选择136例TSN患者,结节数目169个,先行二维超声及彩色多普勒超声检查,发现可疑结节后启动SMI、彩色多普勒血流显像(CDFI)模式进行诊断,比较SMI、CDFI诊断TSN良恶性的敏感度、特异度、阳性预测值、阴性预测值,以及SMI、CDFI模式下良恶性TSN的血流分级和血供分型。结果经病理检查,169个结节中,恶性结节97个(57.40%),良性结节72个(42.60%)。以病理检查结果为金标准,SMI诊断TSN良恶性的敏感度(92.78%)、特异度(95.83%)、阳性预测值(96.77%)、阴性预测值(90.79%)均高于CDFI诊断的敏感度(82.47%)、特异度(80.56%)、阳性预测值(85.11%)、阴性预测值(77.33%)。SMI模式下良性TSN血流检出率(88.89%)高于CDFI模式(68.05%),恶性TSN血流检出率(52.58%)低于CDFI模式(71.13%),差异均有统计学意义(P﹤0.05)。SMI、CDFI模式下良恶性TSN的血流分级和血供分型比较,差异均有统计学意义(P﹤0.05)。结论 SMI可有效判断微小血管及低速血流,准确观察微细血管,敏感度、特异度及血流检出率均较高,在TSN良恶性的辅助诊断上具有较高的应用价值。
Objective To study the diagnostic value of superb microvascular imaging （SMI） in thyroid small nodules （TSN）. Method 136 cases of TSN patients, with a total of 169 nodules, were initially examined by 2D ultrasound and color Doppler ultrasound, while the SMI and color doppler flow imaging （CDFI） were performed for diagnosis of suspect- ed nodules, and then the SMI and CDFI were compared for sensitivity, specificity, as well as positive predictive value and negative predictive value in detecting benign/malignant TSN, of which the blood flow and blood supply detected using SMI and CDFI were analyzed. Result Of the 169 nodules, 97 （57.40%） malignant nodules, and 72 （42.60%） benign nod- ules were confirmed pathologically. Taking pathological findings as the gold standard, the SMI determined benign or ma- lignant TSN with higher sensitivity （92.78%）, specificity （95.83%）, positive predictive value （96.77%）, and negative pre- dictive value （90.79%） than the CDFI mode [sensitivity （82.47%）, specificity （80.56%）, positive predictive value （85.11%）, negative predictive value （77.33%）, respectively]. The detection rate of blood flow （88.89%） in benign TSN was higher using SMI vs using CDFI （68.05%）, while that in malignant TSN was lower in SMI （52.58%） compared with CDFI （71.13%） （P〈0.05）. Overall, SMI and CDFI were significantly different in respect of detecting the blood flow and blood supply for benign and malignant TSN （P〈0.05）. Conclusion SMI can effectively distinguish microvessels and low-velocity blood flow, facilitating accurate observation of microvessels, with acceptable sensitivity, specificity and de- tection rate of blood flow, and is highly applicable for adjuvant diagnosis of benign or malignant TSN.
出处
《癌症进展》
2017年第3期273-276,286,共5页
Oncology Progress
关键词
微血流显像
彩色多普勒血流显像
甲状腺微小结节
诊断
应用价值
superb mircovascular imaging
color Doppler flow imaging
thyroid small nodule
diagnosis
applicationvalue
