| 陈圣,唐力,吴松松,李建卫,林宁.超声多因素分析预测甲状腺髓样癌[J].中国医学影像技术,2020,36(10):1461~1464 |
| 超声多因素分析预测甲状腺髓样癌 |
| Multivariate analysis of ultrasonic features of medullary thyroid carcinoma |
| 投稿时间：2019-06-13 修订日期：2020-03-01 |
| DOI：10.13929/j.issn.1003-3289.2020.10.005 |
| 中文关键词: 甲状腺癌,髓性 超声检查 诊断 |
| 英文关键词:thyroid cancer, medullary ultrasonography diagnosis |
| 基金项目: |
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| 中文摘要: |
| 目的 筛选超声独立预测甲状腺髓样癌（MTC）征象，并分析其诊断效能。方法 选取经病理证实的24例MTC（29个病灶）及同期45例甲状腺良性结节患者（49个病灶），回顾性分析患者性别及超声征象，包括病灶形态、单发与多发、双侧与单侧、边缘、内部回声、内部成分、微钙化、纵横比及血流状况。采用单因素和多因素Logistic回归分析筛选MTC的独立预测因素，计算比值比（OR）及其95%置信区间（CI）。绘制受试者工作特征（ROC）曲线，计算MTC与甲状腺良性结节之间差异有统计学意义因素的曲线下面积（AUC）。结果 多发结节、双侧发病、结节纵横比>1在MTC与甲状腺良性结节之间差异均无统计学意义（P均>0.20）；甲状腺结节血流丰富、低回声、内部微钙化为MTC独立危险预测因素（P均<0.05）。AUC值显示低回声、血流状况、形态不规则、微钙化、边缘不规则诊断MTC效能中等，其中低回声的诊断效能相对较好[AUC=0.77，95%CI（0.68，0.89）]。结论 不同超声征象对MTC的诊断效能不同，甲状腺结节血流丰富、低回声、内部微钙化可作为鉴别诊断MTC与甲状腺良性结节的参考。 |
| 英文摘要: |
| Objective To screen the independent ultrasonography predict factors of medullary thyroid carcinoma (MTC), and to analyze the diagnostic efficacy of these factors. Methods Totally 24 MTC patients (29 lesions) and 45 benign thyroid nodules patients (49 lesions) confirmed by pathology were selected. The gender of patients, as well as the ultrasonic features such as the shape, multiple, bilateral, margin, internal echo, internal components, microcalcification, aspect ratio and blood flow of lesions were retrospectively analyzed. Univariate and multivariate Logistic regression analysis were used to screen the independent predictors of MTC, while odds ratio (OR) and 95% confidence interval (CI) were calculated. The receiver operating characteristic (ROC) curve was drawn, and the area under curve (AUC) of significant factors were calculated. Results There was no significant relationship of multiple, bilateral lesion and aspect ratio>1 with MTC (all P>0.20), whereas rich blood flow, hypoechoic and internal microcalcification were independent risk factors of MTC (all P<0.05). According to AUC value, the diagnostic efficiency of hypoechoic, nodal blood flow, irregular shape, microcalcification and irregular margin were all moderate, among which the diagnostic efficiency of hypoechoic was the best (AUC=0.77, 95%CI[0.68, 0.89]). Conclusion Ultrasonic signs of MTC had different diagnostic efficiencies. Rich blood flow, hypoechoic and internal microcalcification of thyroid nodules might be references for differential diagnosis of MTC. |
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