郭晶晶,薛恩生,俞丽云,梁荣喜,杨嘉嘉,陈舜.不同大小及位置甲状腺微小乳头状癌纵横比与被膜侵犯的关系[J].中国医学影像技术,2018,34(6):850~854
不同大小及位置甲状腺微小乳头状癌纵横比与被膜侵犯的关系
Relationship of aspect transverse ratio and capsule invasion of papillary thyroid microcarcinoma with different size and location
投稿时间:2017-10-03  修订日期:2018-03-31
DOI:10.13929/j.1003-3289.201710005
中文关键词:  甲状腺肿瘤  超声检查  纵横比  被膜
英文关键词:Thyroid neoplasms  Ultrasonography  Aspect transverse ratio  Capsule
基金项目:福建医科大学苗圃基金(2015MP013)。
作者单位E-mail
郭晶晶 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001  
薛恩生 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001 xuees31@163.com 
俞丽云 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001  
梁荣喜 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001  
杨嘉嘉 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001  
陈舜 福建医科大学附属协和医院超声科 福建省超声医学研究所, 福建 福州 350001  
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中文摘要:
      目的 探讨ADC值和相对ADC值(rADC值)鉴别诊断颈部淋巴瘤与转移性淋巴结的价值。方法 对69例淋巴瘤累及颈部淋巴结患者(淋巴瘤组)及66例颈部淋巴结转移患者(转移组)行MR检查,测量淋巴结及咬肌的ADC值,并计算淋巴结rADC值。分析观察者间测量的一致性,比较2组ADC值及rADC值差异。绘制ROC曲线,评价ADC和rADC值鉴别诊断淋巴瘤与转移淋巴结的效能。结果 2名医师测量淋巴结及咬肌ADC值的一致性好(ICC均>0.9),淋巴瘤组ADC值及rADC值均明显低于转移组(P均<0.05)。ADC阈值取0.702×10-3 mm2/s时,其鉴别诊断淋巴瘤与转移淋巴结的敏感度及特异度为98.48%及76.81%;rADC阈值取0.584时,其鉴别诊断淋巴瘤与转移淋巴结的敏感度及特异度为89.39%及84.06%。结论 ADC值及rADC值均能有效鉴别诊断颈部淋巴瘤与转移性淋巴结。
英文摘要:
      Objective To analyze the ultrasonic features of papillary thyroid microcarcinoma (PTMC) with different size and location, and to investigate the relationship of aspect transverse ratio (A/T) and capsule invasion in PTMC. Methods Totally 407 patients of PTMC with 495 nodules confirmed by pathology were enrolled. The nodules were divided into largest diameter ≤ 0.5 cm group and largest diameter>0.5 cm group. The ultrasonic signs of nodules were observed, and the relationship between A/T and thyroid capsule invasion was analyzed. Results The differences of blood type, relationship with capsule, calcification, morphology and A/T were statistically significant between the two groups (all P<0.05). In nodules closed to capsule and A/T ≥ 1, the rate of capsule invasion in diameter>0.5 cm group (117/185, 63.24%) was higher than that in diameter ≤ 0.5 cm group (25/61, 40.98%, P<0.01). Taking A/T ≥ 1 as the standard, the sensitivity of A/T in estimating capsule invasion of nodules closed to capsule in diameter ≤ 0.5 cm group and diameter>0.5 cm group was 89.29% and 73.58%, the specificity was 29.41% and 37.61%, respectively. In nodules adjacent to capsule and broken through capsule, the difference of capsule invasion rate was not significant between nodules with A/T ≥ 1 and A/T<1 (both P>0.05). In nodules that contact capsule, the capsule invasion rate of A/T ≥ 1 nodules (46/67, 68.66%) was higher than that of A/T<1 (10/27, 37.04%). Taking A/T ≥ 1 as the standard, the sensitivity of A/T in estimating capsule invasion of nodules touched capsule was 82.14%, and the specificity was 44.74%. Conclusion Ultrasonography can show the size, A/T and relationship with capsule in PTMC, which can provide diagnostic evidences in judging capsule invasion of PTMC.
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