An Xiuyan, Cong Shuzhen, Qian Jun, Guo Yuping, Zhou Lifeng, Liang Ting
Guangdong Academy of Medical Sciences/ Department of Ultrasound, Guangdong General Hospital, Guangzhou 510080, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2013 Mar;33(3):454-7.
To study the value of ROI A value in the strain ratio and the elasticity scores by the 4-score system in ultrasonic elastography in differential diagnosis of benign and malignant thyroid nodules.
A total of 124 patients with 166 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the elasticity score and the ROI A value in strain ratio. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of ROI A value, and the best cutoff point was determined. The results of diagnosis based on ROI A value, elasticity scores, and their combination were compared with the results of pathological diagnosis.
The area under the ROC curve (Az) of ROI A value for differentiating benign and malignant thyroid nodules was 0.825. The best diagnostic cut-off point of ROI A value was 0.00165. In differentiating benign and malignant thyroid nodules, the sensitivity, specificity, accuracy and odds ratio were 82.93%, 72.80%, 75.30%, and 13.0 for ROI A value, 87.80%, 80.00%, 81.93%, and 28.8 for the elasticity scores, and 73.17%, 91.20%, 86.75%, and 32.1 for their combination, respectively. The odds ratio of the combined diagnosis was the highest, and the accuracy of the combined diagnosis was significantly higher than that of ROI A value (χ(2)=19.31, P<0.05) and the elasticity scores (χ(2)=12.03, P<0.05).
ROI A value has moderate diagnostic value and clinical practicability in differentiating thyroid nodules. The diagnostic accuracy of ROI A value can be improved by combining with the elasticity scores.
探讨应变率比值中的ROI A值及4分制弹性评分在超声弹性成像鉴别甲状腺良恶性结节中的价值。
对124例患者的166个甲状腺结节进行实时超声弹性成像检查，获取弹性评分及应变率比值中的ROI A值。采用受试者操作特征（ROC）曲线评估ROI A值的诊断价值并确定最佳截断点。将基于ROI A值、弹性评分及其联合诊断的结果与病理诊断结果进行比较。
ROI A值鉴别甲状腺良恶性结节的ROC曲线下面积（Az）为0.825。ROI A值的最佳诊断截断点为0.00165。在鉴别甲状腺良恶性结节时，ROI A值的敏感度、特异度、准确度及比值比分别为82.93%、72.80%、75.30%和13.0；弹性评分的分别为87.80%、80.00%、81.93%和28.8；两者联合诊断的分别为73.17%、91.20%、86.75%和32.1。联合诊断的比值比最高，联合诊断的准确度显著高于ROI A值（χ(2)=19.31，P<0.05）及弹性评分（χ(2)=12.03，P<0.05）。
ROI A值在鉴别甲状腺结节方面具有中等诊断价值和临床实用性。联合弹性评分可提高ROI A值的诊断准确性。
