Differential Diagnosis Of Thyroid Suspected Malignant Nodules By Contrast-enhanced Ultrasonography

Objectives To explore the characteristics of thyroid nodular contrast echocardiography,for the differential diagnosis of benign and malignant clinical and provide a noninvasive imaging basis for thyroid disease.Methods Patients with thyroid basic scan,can be malignant thyroid nodules for contrast-enhanced ultrasonography,surgical pathology results or ultrasound guided fine needle aspiration cytology pathological results as a benign and malignant nodular diagnosis of gold standard.The data were analyzed by means of SPSS17.0 statistical software package,and the difference of contrast enhancement model between benign group and malignant group was analyzed.The counting data were expressed as percentage,single factor analysis c 2 test was used.Multivariate screening was performed by Logistic regression model The sensitivity,specificity and specificity of the samples were compared by comparing the sensitivity and specificity of the contrast-induced ultrasonography.Computed sensitivity specificity,Jorden index and ROC curve when ultrasound Basic scanning and ultrasonography combined with different indexes.Determine the type of joint test(series or parallel test)and the best diagnostic efficiency combination.Results 1.Univariate analysis of c2test showed that the identification of thyroid benign and malignant significance of the indicators,the diagnostic efficiency from high to low,followed by: low enhancement,post-angiographic nodule blurred,uneven enhancement,irregular shape,internal microcalcification,Low echo,aspect ratio ? 1,blurred boundaries.2.Multivariate analysis of unconditional logistic regression model analysis showed significant indicators for nodular hypoechoic,irregular morphology,nodular contrast enhancement,nonuniform enhancement,and post-angiographic nodule blurring.3.The screening of the indicators of the diagnostic test and ROC curve comparison shows: low echo performance for the diagnosis of malignant nodules,The diagnostic sensitivity was89.11%,the specificity was 38.07%,the Jordanian index was 0.27,and the area under the ROC curve was 0.607.The diagnostic sensitivity of the nodules was 93.07% And the area under the ROC curve was 0.699.The diagnostic sensitivity was 78.22% and the specificity was 71.43%,and the Gordon index was 0.501,the area under the ROC curve was 0.771,the sensitivity was 84.16%,the specificity was 69.05%,the Gordon index was 0.53,the area under the ROC curve was 0.783,Border blur was used as a marker for the diagnosis of malignant nodules.The diagnostic sensitivity was 88.12%,the specificity was 69.05%,the Gordon index was 0.57,and the area under the ROC curve was 0.777.4.To determine the diagnostic efficiency of the highest joint test: thyroid nodular contrast echocardiography enhanced parallel enhancement after low contrast with the postoperative edge of the nodal blurred results in series,ROC curve area is 0.834.Conclusions 1.Benign and malignant thyroid nodules substantially conventional ultrasound scanning and ultrasound contrast characteristic features is different.2.The diagnosis of malignant nodules meaningful indicators,the diagnostic efficiency from high to low as follows: low enhancement,blurry of nodular boundaries after contrast-enhanced ultrasound,uneven enhancement,irregular shape,hypoechoic.3.Diagnostic suspected malignant thyroid nodules the best diagnostic test: thyroid nodular contrast echocardiography showed nodular enhancement or low enhancement,while blurry of nodular boundaries after contrast-enhanced ultrasound.