| 二维超声联合超声造影诊断甲状腺微小癌的准确性研究 |
| 投稿时间：2016-01-26 修订日期：2016-02-25 点此下载全文 |
| 引用本文：宋磊,侯雪琴,董建,杨凌菲,宋涛.二维超声联合超声造影诊断甲状腺微小癌的准确性研究[J].医学研究杂志,2016,45(9):152-156 |
| DOI：
10.11969/j.issn.1673-548X.2016.09.040 |
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| 中文摘要:目的 本研究旨在评价二维超声联合超声造影诊断甲状腺微小癌的准确性。方法 连续纳入自2013年6月~2015年1月经二维超声检出的直径≤1.0cm的可疑恶性的甲状腺结节患者593例，共853个结节，采用同步、盲法，将超声的检查结果与手术病理结果进行比较，并分别计算二维超声以及二维超声联合超声造影诊断甲状腺微小癌的敏感度（Sen）、特异性（Spe）、准确性、阳性预测值（PV+）、阴性预测值（PV-）、阳性似然比（LR+）、阴性似然比（LR-），将二维超声的敏感度等7个评价指标与二维超声联合超声造影的敏感度等7个评价指标进行比较。结果 ①二维超声诊断甲状腺微小癌的敏感度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为83.1%、80.1%、82.4%、91.7%、65.0%、4.2、0.21；②二维超声联合超声造影诊断甲状腺微小癌的敏感度、特异性、准确性、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为88.4%、83.3%、87.0%、93.1%、73.7%、5.3、0.14；③根据①②得出二维超声联合超声造影诊断甲状腺微小癌与单用二维超声诊断甲状腺微小癌的敏感度、特异性以及准确性的差异均具有统计学意义（P<0.05）。结论 二维超声联合超声造影诊断甲状腺微小癌的准确性明显高于单纯使用二维超声诊断检查，尤其是对于甲状腺微小癌二维超声恶性征象不典型或良性结节具有一定恶性征象的患者，两者联合使用可明显降低其误诊率。 |
| 中文关键词:二维超声 超声造影 诊断准确性研究 甲状腺微小癌 |
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| Accuracy of Contrast-enhanced Ultrasonography Combined with Two-dimensional Ultrasound in the Diagnosis of Thyroid minimal Carcinoma |
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| Abstract:Objective To evaluate the value of contrast-enhanced ultrasonography(CEUS) combined with two-dimensional ultrasound in the diagnosis of thyroid minimal carcinoma(TMC). Methods Totally 593 patients with 853 suspicious nodules were consecutively enrolled into the prospective study during June 2013 and January 2015.The diameter of all nodules ranged from 0.22cm to 1.0cm.The ultrasound findings were compared with surgical pathology,and 7 indices including sensitivity(Sen),specificity(Spe),accuracy,positive predictive value(PV+),negative redictive value(PV-),positive likelihood ratio,negative likelihood ratio were evaluated comprehensively with the statistical method. Results The sensitivity(Sen),specificity(Spe),accuracy,positive predictive value(PV+),negative predictive value(PV-),positive likelihood ratio,negative likelihood ratio of two-dimensional ultrasound and contrast-enhanced ultrasonography combined with two-dimensional ultrasound were 3.1%/88.4%,80.1%/83.3%,82.4%/87.0%,91.7%/93.1%/,65.0%/73.7%,4.2/5.3,0.21/0.14,respectively,and the differences was statistically significant. Conclusion The diagnostic accuracy of contrast-enhanced ultrasonography combined with two-dimensional ultrasound is significantly higher than simple to use two-dimensional ultrasound, especially to suspicious and benign nodules. Both in combination can significantly reduce the rate of misdiagnosis. |
| keywords:Two-dimensional ultrasound Contrast-enhanced ultrasonography Accuracy Study Thyroid minimal carcinoma |
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