应用ROC曲线评价超声弹性成像在甲状腺良恶性结节鉴别诊断中的应用价值

目的探讨超声弹性成像在甲状腺良恶性结节鉴别诊断中的应用价值。方法应用超声弹性成像技术对二维超声检查发现的61例81个甲状腺结节的弹性图像进行评分;按术后病理诊断分为良恶性组,行弹性图像对比分析,并绘制受试者工作特征曲线(ROC曲线),确定诊断界点。结果 61例81个甲状腺结节病理诊断良性66个(良性组),恶性15个(恶性组);良性组弹性图像评分多集中在0～2分(51/66,77.3%),恶性组弹性评分多集中在3～4分(13/15,86.7%),恶性组结节评分明显高于良性组,差异有统计学意义(Z=-3.778,P=0.000)。以弹性评分≥3分为鉴别甲状腺良恶性结节的诊断界点,则诊断灵敏度、特异度及准确性分别为86.7%,81.8%,79.0%;ROC曲线下面积为0.876。结论超声弹性成像有助于对甲状腺良恶性结节进行鉴别诊断,在临床诊断中具有较高的应用价值。

Evaluation of the role of ultrasound elastography in differential diagnosis of benign and malignant thyroid lesions by using curves of receiver operating characteristic

Objective To evaluate the role of ultrasound elastography （UE） and the cut-off value in differentiating benign and malignant lesions in the thyroid. Methods The elastograms of 81 thyroid lesions in 61 patients were retrospectively analyzed and curves of receiver operating characteristic（ROC） were used to assess the role of ultrasound elastography（UE） in differentiating benign and malignant lesions of the thyroid and the cut-off value was chosen. Results There were significant differences in the elastographic scores between benign and malignant lesions. Malignant lesions had a higher score than benign ones. The area under ROC curve was 0.876. If the cut-off value of the elastographic scores was equal to or more than 3, the sensitivity, specificity and accuracy was 86.7% ,81.8% ,79.0% respectively. Conclusions UE is helpful for differentiating benign and malignant lesions of thyroid with high value.