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目的比较弹性比值法和评分法对甲状腺结节的诊断价值,从而为临床提供可靠的诊断方法。方法用超声弹性成像技术检查156个甲状腺结节,分别采用弹性比值法和弹性评分5分法对弹性图像进行评价,以甲状腺结节穿刺活检或术后病理做为对照。对两种方法的诊断作用做受试者工作特征曲线(ROC),分别得到曲线下面积和最佳分界点。采用χ2检验比较这两种方法的敏感性、特异性和准确性。P<0.05有统计学意义。结果根据ROC曲线,弹性比值法和评分法分别以3.855和4分为最佳分界点。弹性比值法的敏感性80.00%(40/50)、特异性90.57%(96/106)、准确性87.18%(136/156),弹性评分法的敏感性84.00%(42/50)、特异性78.30%(83/106)、准确性80.13%(125/156)。弹性比值法的特异性显著高于评分法(P<0.05)。结论弹性比值法对甲状腺结节的诊断价值较弹性评分法高,对甲状腺结节性质的判断更客观更可靠。
Objective To compare the diagnostic value of flexible ratio method and scoring method for thyroid nodules and to provide a reliable diagnostic method for clinical practice. Methods 156 thyroid nodules were examined by ultrasound elastography. Elasticity and flexion score were respectively used to evaluate elastic images. Thyroid nodules biopsy or postoperative pathology was used as control. The receiver operating characteristic curve (ROC) was used to diagnose the two methods and the area under the curve and the best cut-off point were obtained respectively. Chi-square test was used to compare the sensitivity, specificity and accuracy of the two methods. P <0.05 was statistically significant. Results According to the ROC curve, the elastic ratio method and the grading method were 3.855 and 4 respectively, the best cut-off point. The sensitivity of the elastic ratio method was 80.00% (40/50), the specificity was 90.57% (96/106), the accuracy was 87.18% (136/156), the elasticity was 84.00% (42/50), the specificity 78.30% (83/106), accuracy 80.13% (125/156). The specificity of the elastic ratio method was significantly higher than the score method (P <0.05). Conclusion The elastic ratio method is superior to elastic scoring method in the diagnosis of thyroid nodules, and is more objective and reliable in judging the nature of thyroid nodules.