摘要
目的 构建基于超声图像特征和临床特征的甲状腺结节良恶性预测模型,并评估其诊断效能.资料与方法 回顾性分析2020年9月—2022年3月北部战区总医院收治的121例甲状腺结节患者资料,以手术病理为"金标准",其中良性结节70个,恶性结节51个.通过Logistic回归分析甲状腺结节的超声图像特征及临床资料,得出差异有统计学意义的特征指标,并建立综合预测模型.结果 甲状腺良、恶性结节的超声特征中,结节最大径、形态、钙化、被膜连续性、血流分级、弹性成像评分、超声造影特征差异均有统计学意义(χ2=11.709、17.707、6.901、12.785、16.984、57.095、98.854,P均<0.05).临床指标中,年龄、游离甲状腺激素、游离三碘甲状腺原氨酸/游离甲状腺激素比值差异均有统计学意义(χ2/t=5.944、2.519、-2.468,P 均<0.05).临床模型、超声特征模型、超声-临床联合模型检出恶性病变的敏感度分别为 55.7%、98.6%、97.0%,特异度分别为72.5%、94.1%、96.1%,准确度分别为61.9%、95.1%、95.9%.3种模型的曲线下面积分别为0.619、0.991、0.994,超声特征模型、联合模型的诊断效能均优于临床模型,差异有统计学意义(Z=-1.75、-2.25,P=0.039、0.012),联合模型的曲线下面积大于超声特征模型,但差异无统计学意义(Z=-1.60,P=0.054).结论 多模态超声模型和临床模型预测甲状腺结节良恶性均具有一定诊断价值,多模态超声模型的诊断效能高于临床模型,两者联合后的联合模型可提高诊断价值.
Abstract
Purpose To construct a benign and malignant prediction model of thyroid nodules based on ultrasound image features and clinical features,and to evaluate its diagnostic efficacy.Materials and Methods The data of 121 patients diagnosed with thyroid nodules admitted to the General Hospital of Northern Theater Command from September 2020 to March 2022 were retrospectively analyzed.Taken surgical pathology as the gold standard,there were 70 benign nodules and 51 malignant nodules.Logistic regression was used to analyze the ultrasound image characteristics and clinical data of thyroid nodules,and the characteristic indexes with statistical differences were obtained and a comprehensive prediction model was established.Results There were significant differences in the maximum diameter,morphology,calcification,capsule continuity,blood flow grade,elastography score and contrast-enhanced ultrasound characteristics between benign and malignant thyroid nodules(χ2=11.709,17.707,6.901,12.785,16.984,57.095,98.854,all P<0.05).There were significant differences in age,free thyroxine/free thyroxine ratio,and free thyroxine between the two groups(χ2/t=5.944,2.519,-2.468,all P<0.05).The sensitivity,specificity and accuracy of the clinical model,ultrasonic characteristic model and ultrasonic-clinical combined model were 55.7%,98.6%and 97.0%;72.5%,94.1%and 96.1%;and 61.9%,95.1%and 95.9%,respectively.The area under the curve of the three models were 0.619,0.991 and 0.994,respectively.The diagnostic efficiency of the ultrasonic characteristic model and the combined model was superior to the clinical model,and the difference was statistically significant(Z=-1.75,-2.25,P=0.039,0.012).The area under the curve of the combined model was greater than that of the multi-modal ultrasound model,however,the difference was not statistically significant(Z=-1.60,P=0.054).Conclusion Both the multimodal ultrasound model and the clinical model have certain diagnostic value in predicting benign and malignant thyroid nodules.The diagnostic efficiency of the multimodal ultrasound model is higher than that of the clinical model,and the combined prediction model of the two can improve the diagnostic value.
基金项目
辽宁省重点研发计划项目(2020JH2/10300122)
沈阳市科学技术计划(20-205-4-058)
维普
万方数据