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甲状腺癌结节患者的定量超声成像参数:诊断模型的建立

Quantitative ultrasound imaging parameters in patients with cancerous thyroid nodules: development of a diagnostic model.

作者信息

Liu Mingyang, Pan Na

机构信息

Department of Ultrasound, Xingtai People's Hospital No. 16 Hongxing Street, Xingtai 054500, Hebei, China.

Department of Hematology, Xingtai People's Hospital No. 16 Hongxing Street, Xingtai 054500, Hebei, China.

出版信息

Am J Transl Res. 2024 Jun 15;16(6):2645-2653. doi: 10.62347/WEDG9279. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to develop a diagnostic model utilizing quantitative ultrasound parameters to accurately differentiate benign from malignant thyroid nodules.

METHODS

A retrospective analysis of 194 patients with thyroid nodules, encompassing 65 malignant and 129 benign cases, was performed. Clinical data, ultrasound characteristics, and hemodynamic indicators were compared. Receiver operating characteristic (ROC) curves and logistic regression analysis identified independent diagnostic markers.

RESULTS

No significant differences in clinical data were observed between the groups (P>0.05). Malignant nodules, however, were more likely to exhibit solid composition, hypoechoicity, irregular shapes, calcifications, central blood flow, and unclear margins (P<0.05). Hemodynamic parameters showed that malignant nodules had lower end-diastolic volume (EDV) but higher peak systolic velocity (PSV), resistive index (RI), and vascularization flow index (VFI) (P<0.001). Independent diagnostic factors identified included calcification, margin definition, RI, and VFI. A risk prediction model was formulated, demonstrating significantly lower scores for benign nodules (P<0.0001), achieving an ROC area of 0.964.

CONCLUSION

Color Doppler ultrasound effectively distinguishes malignant from benign thyroid nodules. The diagnostic model emphasizes the importance of calcification, margin clarity, RI, and VFI as critical elements, enhancing the accuracy of thyroid nodule characterization and facilitating informed clinical decisions.

摘要

目的

本研究旨在开发一种利用定量超声参数的诊断模型,以准确区分甲状腺良恶性结节。

方法

对194例甲状腺结节患者进行回顾性分析,其中包括65例恶性病例和129例良性病例。比较临床资料、超声特征和血流动力学指标。采用受试者操作特征(ROC)曲线和逻辑回归分析确定独立诊断标志物。

结果

两组间临床资料无显著差异(P>0.05)。然而,恶性结节更易表现为实性成分、低回声、形状不规则、钙化、中央血流和边界不清(P<0.05)。血流动力学参数显示,恶性结节的舒张末期容积(EDV)较低,但收缩期峰值流速(PSV)、阻力指数(RI)和血管化血流指数(VFI)较高(P<0.001)。确定的独立诊断因素包括钙化、边界清晰度、RI和VFI。制定了一个风险预测模型,结果显示良性结节的得分显著较低(P<0.0001),ROC曲线下面积为0.964。

结论

彩色多普勒超声能有效区分甲状腺良恶性结节。该诊断模型强调钙化、边界清晰度、RI和VFI作为关键要素的重要性,提高了甲状腺结节特征描述的准确性,有助于做出明智的临床决策。

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