彩色多普勒超声与ECT诊断甲状腺结节的价值比较

目的]比较彩色多普勒超声和单光子发射计算机断层扫描(ECT)诊断甲状腺低回声结节良恶性的价值。方法]2名高年资医师分别采用双盲法独立回顾性分析同时行彩色多普勒超声和ECT的甲状腺低回声结节影像学特征,并作出诊断。对照病理,绘制ROC(receiver operating characteristic,ROC)曲线分析两种方法诊断价值。结果]41个甲状腺结节,病理诊断恶性结节27个,良性结节14个;超声诊断恶性结节24个,良性结节17个,ECT诊断恶性结节39个,良性结节2个,两种方法诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为88.9%、100.0%、100.0%、82.4%、92.7%和92.6%、14.3%、67.5%、50.0%、65.9%。超声和ECT诊断甲状腺结节ROC曲线下面积分别为0.94和0.53,差异有统计学意义(P<0.0001)。结论]彩色多普勒超声诊断甲状腺良恶性结节的价值优于ECT。

CDUS and ECT compared in differential diagnosis of thyroid nodules

Objective] To assess the value of color doppler ultrasonography （CDUS} and emission-computed tomography in differential diagnosis benign thyroid nodules from malignant nodules with low echo level. Methods ] Retrospectively, two high qualification doctors respectively analysed the characteristics of forty - one thyroid nodules on imaging pictures with double blind methods, and then made the diagnosis. Compared with pathology, comparison of ROC curves of the two methods were drawn, and the diagnostic sensitivity,specificity,positive predictive value, negative predictive value and accuracy rate of color doppler CDUS and single photon emission - computed tomography （ ECT ） in differential diagnosis of benign and malignant were evaluated. Results ] Compared with pathology, of the forty - one nodules, twenty- seven thyroid nodules were benign and fourteen thyroid nodules were malignant. Twenty-four malignant thyroid nodules and seventeen benign thyroid nodules were diagnosed by CDUS. Thirty - nine malignant nodules and two benign thyroid nodules were diagnosed by ECT. The diagnostic sensitivity, specificity,positive predictive value,negative predictive value and accuracy rate of CDUS and ECT were 88.9% ,100.0% ,100.0% ,82.4% ,92.7% and 92.6%, 14.3% ,67.5% ,50.0% ,65.9%, respectively. The areas under the curves of US and ECT were 0.95 and 0.53, respectively. There was statistical difference between the two methods { P 〈 0.0001 }. Conclusion ] CDUS has higher diagnosis value in differentiating malignant thyroid nodules from those that are benign than ECT.