|本期目录/Table of Contents|

[1]陶迅,童清平,杜欢,等.超声联合弹性成像及促甲状腺激素水平对甲状腺良恶性病变的诊断价值[J].医学研究与战创伤救治(原医学研究生学报),2018,20(03):232-235.[doi:10.3969/j.issn.1672-271X.2018.03.003]
　TAO Xun,TONG Qing-ping,DU Huan,et al.The thyrotropin levels in combination of ultrasound and elastography on diagnosis of benign and malignant thyroid lesions[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(03):232-235.[doi:10.3969/j.issn.1672-271X.2018.03.003]
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超声联合弹性成像及促甲状腺激素水平对甲状腺良恶性病变的诊断价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年03期
页码:
232-235
栏目:
出版日期:
2018-05-09

文章信息/Info

Title:
The thyrotropin levels in combination of ultrasound and elastography on diagnosis of benign and malignant thyroid lesions
作者:
陶迅; 童清平; 杜欢; 陈金锦
作者单位：230031合肥，安徽医科大学解放军临床学院（解放军第一○五医院）超声中心（陶迅、童清平、杜欢、陈金锦）
Author(s):
TAO Xun; TONG Qing-ping; DU Huan; CHEN Jin-jing
（Ultrasonic Center, PLA Clinical Hospital of Anhui Medical University/the 105th Hospital of PLA,Hefei 230031，Anhui,China）
关键词:
超声; 甲状腺; 弹性成像; 促甲状腺激素
Keywords:
ultrasonography;  thyroid;  elastography;  thyrotropin
分类号:
R445.1
DOI:
10.3969/j.issn.1672-271X.2018.03.003
文献标志码:
A
摘要:
目的 探讨超声联合弹性成像及血清促甲状腺激素（thyrotropin，TSH）水平对甲状腺良恶性病变的辅助诊断价值。方法 回顾性分析114例甲状腺结节患者临床资料，所有患者术前均行血清TSH检查、常规超声及弹性成像检查，结节均采用甲状腺影像报告和数据系统（TI-RADS）分级及弹性成像Itoh5分法进行评分。以病理诊断为金标准，分析术前血清TSH与甲状腺结节的相关性，并依据血清TSH结果 对超声联合弹性诊断甲状腺结节的评分结果 进行修正。利用ROC曲线比较单纯超声、超声联合弹性成像和超声联合弹性成像及血清TSH对甲状腺结节的诊断价值，计算出三者之间的敏感度、特异度、准确度、阳性预测值、阴性预测值。结果 TSH与甲状腺结节大小具有较好相关性（r=0258，P<005），TSH预测甲状腺癌的ROC曲线下面积（AUC）为061，最佳临界值为1.02μIU/mL，单纯超声、超声联合弹性成像和超声联合TSH及弹性成像的AUC分别为0861、0968、0955，2种联合诊断方法 与单纯超声诊断比较差异均有统计学意义（Z=3.12、2.97，P<005），两者之间差异无统计学意义（Z=1.07，P＞005）。超声联合弹性成像诊断甲状腺癌准确度最高（85.2%）。结论 超声联合弹性成像有助于提高甲状腺良恶性病变的鉴别诊断价值，单独利用术前血清TSH水平在诊断甲状腺癌上有一定价值，但作为超声的辅助诊断指标并无明显诊断价值。
Abstract:
Objective To investigate the value of serum thyrotropin (TSH) levels in the diagnosis of benign and malignant thyroid diseases with ultrasound combined with elastography.Methods 114 cases of thyroid nodules were selected who underwent preoperative TSH examination, routine ultrasonography and elastography examination. All the nodules were scored using the thyroid imaging report and data system (TI-RADS) classification and the Itoh 5 score. The correlation between serum TSH and thyroid nodule was analyzed by using pathological diagnosis as gold standard, and the score of ultrasonography combined with elastic diagnosis of thyroid nodule was revised according to serum TSH Results . Diagnostic value of ultrasound, ultrasound combined with elastic, ultrasound combined elastography and serum TSH were researched by the ROC curve, sensitivity, specificity, accuracy, positive predictive value. Negative predictive values were obtained between the three Methods .Results There was a good correlation between TSH and the size of thyroid nodules (r=0.258, P＜0.05). The area under ROC curve (AUC) predicted by TSH in thyroid carcinoma was 0. 61, the op-timal critical value of TSH for predicting thyroid cancer was 1.02 μIU/mL. AUC of simple ultrasound combined with elastography and ultrasound combined with TSH and elastography was 0.861, 0.968, 0.955. There was a significant difference between the two combined diagnostic Methods (Z=3.12, 2.97, P＜0.05), but there was no significant difference between the two Methods (Z=1.07, P＞0.05). The accuracy of ultrasound combined with elastography in diagnosing thyroid carcinoma was the highest (85.2%). Conclusion Ultrasound combined with elastography is helpful to improve the differential diagnosis of benign and malignant thyroid lesions. Preoperative serum TSH level is valuable in the diagnosis of thyroid carcinoma, but it is not valuable for the diagnosis of ultrasound as an auxiliary diagnostic marker.

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备注/Memo

备注/Memo:
基金项目：南京军区医学科技创新课题（12MA030）
更新日期/Last Update: 2018-05-20